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Obesity Surgery

, Volume 19, Issue 11, pp 1485–1490 | Cite as

Short-Term Morbidity and Mortality After Open Versus Laparoscopic Gastric Bypass Surgery. A Population-Based Study from Sweden

  • Richard Marsk
  • Per Tynelius
  • Finn Rasmussen
  • Jacob Freedman
Clinical Research

Abstract

Background

The number of anti-obesity procedures performed continues to increase and most are now performed laparoscopically. Few population-based studies have examined outcomes after open and laparoscopic anti-obesity surgery.

Methods

All-cause mortality and cause-specific morbidity was studied in patients who underwent laparoscopic or open gastric bypass (GBP) surgery in all public Swedish hospitals between 1997 and 2006.

Results

Four thousand seven hundred one (3,852 primary) GBP procedures were performed during the study period. Of these, 1,661 were performed laparoscopically and 3,040 by open access. There was no difference in 30-, 90-, or 365-day mortality between open and laparoscopic access. Complications were more common after conversion from previous anti-obesity surgery to GBP (OR 1.9; 95% CI 1.5–2.4; 30-day readmission). Surgical re-intervention due to anastomotic leak or deep infection was higher in laparoscopic GBP compared to open GBP (OR 2.1; 1.3–3.6). Subgroup analysis showed higher leak rates with revisional laparoscopic procedures (conversion to GBP from previous anti-obesity surgery) compared to revisional open (OR 4.1; 1.5–11.2) whereas after primary GBP no statistically significant difference was seen between laparoscopic and open approach (OR 1.7; 1.0–3.1) (p = 0.07).

Conclusion

Laparoscopic GBP is as safe as open surgery in terms of mortality. Care needs to be taken when converting previous anti-obesity surgery to GBP.

Keywords

Gastric bypass Obesity Bariatric surgery Morbidity Mortality Epidemiology Cohort study 

Notes

Acknowledgements

This study was supported by the Swedish Research Council, Stockholm Council and Funds of the Karolinska Institutet.

Disclosure

None of the authors have any conflict of interest and nothing to declare.

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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Richard Marsk
    • 1
  • Per Tynelius
    • 2
  • Finn Rasmussen
    • 2
  • Jacob Freedman
    • 1
  1. 1.Division of Surgery, Department of Clinical Sciences, Danderyd HospitalKarolinska InstitutetStockholmSweden
  2. 2.Department of Public Health SciencesKarolinska InstitutetStockholmSweden

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