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Prediction Factors of Early Postoperative Bleeding after Bariatric Surgery

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Identifying the possible predictors of postoperative bleeding is advantageous to reduce healthcare costs and promote patients’ recovery. The aim of this study was to determine early postoperative bleeding predictors after bariatric surgery.

Materials and Methods

This retrospective study was conducted using data from 2260 patients who underwent bariatric surgery. We diagnosed early postoperative bleeding by the following symptoms: abdominal pain, hypotension, tachycardia, hematemesis, melena, decreased hemoglobin level, the need for at least two units of packed red blood cells (PRBCs) transfusion, and reoperation within the first 48 h after surgery.


Our results showed the odds of early postoperative bleeding in laparoscopic Roux-en-Y gastric bypass (LRYGB) were higher than in laparoscopic sleeve gastrectomy (LSG) (OR 3.49, 95% CI 1.79 to 6.80). In addition, prior intragastric balloon (IGB) (OR 3.14, 95% CI 1.18 to 8.34) and oral non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) (OR 5.91, 95% CI 1.79 to 20.63) were positively associated with the occurrence of postoperative bleeding. In contrast, there was an inverse relationship between staple line oversewing and the odds of postoperative bleeding (OR 0.18, 95% CI 0.04 to 0.81). After stratification data based on the type of the surgery, the positive association between IGB and the odds of bleeding was constant in the LRYGB group. In the LSG group, use of non-aspirin NSAIDs was linked to a higher incidence of postoperative bleeding, while oversewing of the staple line lowered the incidence of this event.


Our results demonstrated a positive association between type of procedure, history of IGB, and oral non-aspirin NSIADs use, as well as an inverse relationship between staple line oversewing and the odds of bleeding after bariatric surgery.

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Authors and Affiliations



All authors contributed to the study’s design, as well as data collection, analysis, and interpretation. The manuscript was prepared by all of the authors, and they all approved the final version. Furthermore, all authors accept responsibility for all parts of the work, including ensuring that any concerns about its accuracy or integrity are thoroughly investigated and resolved.

Corresponding author

Correspondence to Karamollah Toolabi.

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For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key points

• Prior IBG, use of non-aspirin NSAIDs, and non-staple line oversewing were determined as predictors of bleeding in patients who have undergone bariatric surgery.

• In the LRYGB group, prior IGB history was associated with a higher incidence of postoperative bleeding.

• In the LSG group, there was an inverse association between oversewing of the staple line and the odds of early postoperative bleeding but a positive association between use of non-aspirin NSIADs and this event.

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Golzarand, M., Toolabi, K. & Parsaei, R. Prediction Factors of Early Postoperative Bleeding after Bariatric Surgery. OBES SURG 32, 1–8 (2022).

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