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Published on: November 14, 2020
Current trends in reoperative bariatric surgery using MBSAQIP database 2020-2023
Cody M Crnkovic1, Maria Raye Anne Ng1, Noah Jordan1
1Department of Surgery, University of Kentucky, Lexington, Kentucky.
Background:
Reoperative bariatric surgeries continue to increase every year, and indications and outcomes have changed over time.
Objective:
The aim of this study is to assess trends and 30-day outcomes of elective reoperative metabolic and bariatric surgeries (MBS) between 2020 and 2023.
Setting:
National database, United States.
Methods:
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from 2020 to 2023 was evaluated. Elective reoperations were included in the analysis while emergent and rare procedures were excluded. Comprehensive descriptive statistics were reported for pooled and stratified data. Preoperative variables and postoperative outcomes were compared.
Results:
Of 828,481 surgeries, 90,410 elective reoperations occurred (10.9%) between 2020 and 2023. Sleeve gastrectomy (SG) reoperations were the most common. Of these, 39,265 (80.9%) were converted to Roux-en-Y gastric bypass (RYGB), and 5331 (11%) to duodenal switch (DS)/single anastomosis duodenal-ileal bypass (SADI). Common indications for reoperation were weight recurrence/non-responders (53.7%) and gastroesophageal reflux (32.2%). Laparoscopic adjustable gastric band (LAGB) conversion to RYGB had higher complication rates than LAGB to SG (5.9% vs 3.4%). Conversion from SG to RYGB had higher complication rates compared with conversion to SADI or DS (5.9% vs 4.6% and 3.6%); however, SG to RYGB had lower rates of major complication (leak, deep space surgical site infection (SSI), and gastrointestinal bleeding).
Conclusion:
Reoperative bariatric surgery procedures have remained relatively stable over recent years. SG is the most common primary MBS procedure as well as the most frequent requiring re-operation. While complication rates continue to be low for elective re-operative bariatric surgeries, comprehensive evaluation and counseling are vital for informed decision-making with patients. Objective assessment of indication and patient factors are necessary when choosing reoperative procedures.
