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Obesity Surgery

, Volume 26, Issue 1, pp 12–20 | Cite as

Complications After Laparoscopic Roux-en-Y Gastric Bypass in 1573 Consecutive Patients: Are There Predictors?

  • Anna Dayer-Jankechova
  • Pierre Fournier
  • Pierre Allemann
  • Michel SuterEmail author
Original Contributions

Abstract

Background

Roux-en-Y gastric bypass (RYGBP), one of the commonest performed bariatric procedures, remains a technically challenging operation associated with significant morbidity in high-risk patients. This study was conducted in order to identify predictors of complications after laparoscopic RYGBP.

Methods

Our prospectively established database has been assessed to review 30-day and in-hospital complications graded according to a validated scoring system (Clavien–Dindo) and separated into minor (Clavien–Dindo I–IIIa) and major (Clavien–Dindo IIIb–IV) complications. Patient- and procedure-related factors were analyzed using univariate analysis. Significant factors associated with morbidity were introduced into a multivariate analysis to identify independent predictors.

Results

Between 1999 and 2012, 1573 patients underwent laparoscopic RYGBP, 374 male and 1199 female. Mean age was 41 years, and mean body mass index (BMI) was 44.5 kg/m2. One hundred fifty-nine procedures were reoperations. One hundred fifty (9.5 %) patients developed at least one complication, and 43 (2.7 %) had major complications, leading to death in one case (0.06 %). Risk factors for morbidity were male gender (p = 0.006) and overall experience of the team (p < 0.0001). Prolonged 3-day antibiotic therapy was associated with significantly reduced overall (p < 0.0001) and major (p = 0.005) complication rates. Major complications were associated with smoking (p = 0.016).

Conclusions

The most significant individual risk factors for early complications after RYGBP are male gender, limited surgical experience, and single dose of antibiotics. RYGBP should be performed by experienced teams. Smoking should be discontinued before surgery. Prolonged antibiotic therapy could be considered, especially if a circular stapled gastrojejunostomy is performed with the anvil introduced transorally.

Keywords

Roux-en-Y gastric bypass Complications Risk factors Morbid obesity Laparoscopy 

Notes

Conflict of Interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this is a retrospective study, no ethical committee was sought.

Informed Consent

All patients gave informed consent before operation, which included consent for the procedure as well as for follow-up, inclusion in our databases, and deidentified outcome data reporting.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Anna Dayer-Jankechova
    • 1
    • 2
  • Pierre Fournier
    • 1
  • Pierre Allemann
    • 1
  • Michel Suter
    • 1
    • 2
    Email author
  1. 1.Department of Visceral SurgeryCentre Hospitalier Universitaire Vaudois (CHUV)LausanneSwitzerland
  2. 2.Department of SurgeryHôpital Riviera-Chablais (HDC)Aigle–MontheySwitzerland

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