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Bariatric Surgery: Low Mortality at a High-Volume Center

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Abstract

Background

The American Society of Bariatric Surgery has initiated a Bariatric Surgery Center of Excellence Program and the American College of Surgeons has followed with their Bariatric Surgery Center Network Accreditation Program. These programs postulate that concentration of weight loss operations in high-volume centers will decrease surgical mortality and improve outcomes.

Methods

The purpose of this study was to calculate the in-hospital mortality for bariatric operations accomplished at the highest volume bariatric surgery center in the state of New Jersey. After receiving Institutional Revew Board approval, the revised surgical schedule was used to identify all patients undergoing weight loss surgery (WLS) at Hackensack University Medical Center from 1998 through June, 2006. Data for these patients were then harvested from the hospital’s electronic medical record. Step-wise and univariate logistic regression analysis tested the impact of various factors on hospital length of stay and in-hospital mortality.

Results

Between 1998 and June, 2006, 5,365 patients underwent WLS surgery: 2,099 open vertical banded gastroplasty–Roux en Y gastric bypass (VBG–RYGB); 2,177 laparoscopic Roux en Y gastric bypass (LRYGB); and 1,089 laparoscopic adjustable gastric banding (LAGB). 75.5% of patients were women. Median age was 41 years old (13–79), median weight 128 kg (81.2–290.3), and median body mass index 46.1 kg/m2 (35.0–92.6). Median total operating room time for VBG–RYGB was 115 min (33–328); LRYGB 155 min (53–493), and LAGB 92 min (33–274). Median length of stay for VBG–RYGB was 3 days (1–39 days), LRYGB 2 days (1–46 days), and LAGB 1 day (1–20). Seven patients died in hospital after the 5,365 WLS operations (0.13%): four after VBG–RYGB (0.19%); three after LRYGB (0.14%); and none after LAGB (0%). The characteristics of the patients who died did not significantly differ from the group as a whole.

Conclusion

Surgeons at Hackensack University Medical Center, a high volume, accredited 1A American College of Surgeons Bariatric Surgery Center, achieved a 0.13% mortality among 5,365 patients undergoing weight loss operations between 1998 and June, 2006. This study supports the concept that high-volume centers perform bariatric operations with low mortalities.

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Abbreviations

VBG–RYGB:

Vertical Banded Gastroplasty–Roux-en-Y gastric bypass

LRYGB:

Laparoscopic Roux-en-Y Gastric Bypass

LAGB:

Laparoscopic Adjustable Gastric Banding

WLS:

Weight Loss Surgery

ASA:

American Society of Anesthesiologists

BMI:

Body Mass Index

HUMC:

Hackensack University Medical Center

LOS:

Length of Stay

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Author notes

  1. Garth H. Ballantyne

    Present address: , 20 Prospect Avenue, Suite #901, Hackensack, NJ, USA

Authors and Affiliations

  1. Bariatric Surgery Center, Hackensack University Medical Center, Hackensack, NJ, USA

    Garth H. Ballantyne, Scott Belsley, Daniel Stephens, John K. Saunders, Amit Trivedi, Douglas R. Ewing, Vincent Iannace, Daniel Davis, Rafael F. Capella, Annette Wasielewski, S. Moran & Hans J. Schmidt

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  1. Garth H. Ballantyne
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  2. Scott Belsley
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  3. Daniel Stephens
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  4. John K. Saunders
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  6. Douglas R. Ewing
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  7. Vincent Iannace
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  8. Daniel Davis
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  9. Rafael F. Capella
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  10. Annette Wasielewski
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  12. Hans J. Schmidt
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Corresponding author

Correspondence to Garth H. Ballantyne.

Additional information

Author Contribution: Study conception & design: Ballantyne, Belsley, Stephens, Saunders, Trivedi, Ewing, Iannace, Davis, Capella, Wasielewski, Moran, Schmidt. Acquisition of data: Ballantyne, Belsley, Dtephens, Saunders, Moran. Analysis & interpretation of data: Ballantyne, Moran. Drafting of manuscript: Ballantyne, Belsley, Stephens, Saunders, Trivedi, Ewing, Iannace, Davis, Capella, Wasielewski, Moran, Schmidt. Critical revision: Ballantyne, Belsley, Stephens, Saunders; Trivedi, Ewing, Iannace, Davis, Capella, Wasielewski, Moran, Schmidt.

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Ballantyne, G.H., Belsley, S., Stephens, D. et al. Bariatric Surgery: Low Mortality at a High-Volume Center. OBES SURG 18, 660–667 (2008). https://doi.org/10.1007/s11695-007-9357-y

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  • DOI: https://doi.org/10.1007/s11695-007-9357-y

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