Langenbeck's Archives of Surgery

, Volume 402, Issue 6, pp 885–899 | Cite as

Outcomes after bariatric surgery according to large databases: a systematic review

  • Andrea Balla
  • Gabriela Batista Rodríguez
  • Santiago Corradetti
  • Carmen Balagué
  • Sonia Fernández-Ananín
  • Eduard M. Targarona
Systematic Reviews and Meta-analyses



The rapid development of technological tools to record data allows storage of enormous datasets, often termed “big data”. In the USA, three large databases have been developed to store data regarding surgical outcomes: the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). We aimed to evaluate the clinical impact of studies found in these databases concerning outcomes of bariatric surgery.


We performed a systematic review using the Meta-analysis of Observational Studies in Epidemiology guidelines. Research carried out using the PubMed database identified 362 papers. All outcomes related to bariatric surgery were analysed.


Fifty-four studies, published between 2005 and February 2017, were included. These articles were divided into (1) outcomes related to surgical techniques (12 articles), (2) morbidity and mortality (12), (3) 30-day hospital readmission (10), (4) outcomes related to specific diseases (11), (5) training (2) and (6) socio-economic and ethnic observations in bariatric surgery (7). Forty-two papers were based on data from ACS-NSQIP, nine on data from NIS and three on data from MBSAQIP.


This review provides an overview of surgical management and outcomes of bariatric surgery in the USA. Large databases offer useful complementary information that could be considered external validation when strong evidence-based medicine data are lacking. They also allow us to evaluate infrequent situations for which randomized control trials are not feasible and add specific information that can complement the quality of surgical knowledge.


NSQIP NIS MBSAQIP Bariatric surgery Systematic literature review 


Authors’ contributions

Andrea Balla: study design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of manuscript; Gabriela Batista Rodríguez: study design, acquisition of data, analysis and interpretation of data, critical revision of manuscript; Santiago Corradetti: acquisition of data, analysis and interpretation of data, critical revision of manuscript; Carmen Balagué: study design, analysis and interpretation of data, critical revision of manuscript; Sonia Fernández-Ananín: study design, analysis and interpretation of data, critical revision of manuscript; Eduard M. Targarona: study conception and design, analysis and interpretation of data, critical revision of manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.General and Digestive Surgery UnitHospital de la Santa Creu i Sant Pau, Universidad Autónoma de BarcelonaBarcelonaSpain
  2. 2.Department of General Surgery and Surgical Specialties “Paride Stefanini”Sapienza, University of RomeRomeItaly
  3. 3.Surgical Oncology Unit, Department of Hemato-OncologyHospital Dr. Rafael A. Calderón GuardiaSan JoséCosta Rica

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