Sahil Gambhir, MD, Reza F Alizadeh, MD, Colette S Inaba, MD, Megan T Smith, PhD, Jeffry Nahmias, MD, Brian R Smith, MD, Ninh T Nguyen, MD, Shaun Daly, MD. University of California Irvine Medical Center
Introduction/Objectives: Postoperative venous thromboembolism (VTE) is a leading cause of morbidity and mortality in bariatric surgery. There is limited data comparing VTE disease between various types of bariatric surgery. Operative time has been found to be an independent predictor of postoperative VTE. We hypothesized the incidence of VTE would be higher in Laparoscopic Gastric Bypass (LRYGB) compared to Laparoscopic Sleeve Gastrectomy (LSG) and operative time could be an independent predictor.
Methods: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was queried to identify patients who underwent LSG or LRYGB between 2015- 2016. Perioperative data were compared using univariate analysis including t-tests and Fischer’s test. Adjusted odds ratios (AOR) for the risk of deep venous thrombosis and/or pulmonary embolus (PE) were determined using multivariable logistic regression analysis.
Results: During the study period 167,563 (71%) patients underwent LSG and 67,525 (29%) underwent LRYGB. Demographics were similar between both groups, including age, sex, body mass index, history of DVT (1.37% versus 1.78%), history of PE (1.02% vs. 1.18%) and history of smoking (8.91% vs. 8.72%) respectively. Patients diagnosed with perioperative PE have longer operative times in both LSG (86 mins vs. 65 mins) and LRYGB (135 minutes vs. 108 minutes) than patients without diagnosis of PE. LRYGB patients experience longer length of stay (2.06 days vs. 1.62 days). There was no significant difference in risk of postoperative DVT between LSG and LRYGB (OR 0.968, CI 0.767-1.220, p>0.05). Compared to LRGYB, LSG was associated with decreased risk of pulmonary embolism (PE) (AOR 0.614, CI 0.462-0.816 p=0.004). LRGYB patients with PEs had a statistically longer operative time compared to LSG patients with PEs (135 minutes vs. 86 minutes; p=0.001).
Conclusion: Patients undergoing either LSG or LRYGB and have longer operative times, have a higher incidence of PE. However, LSG confers a lower risk of pulmonary embolism compared to LRYGB. After multivariate analysis, operative time is an independent risk factor for higher PE rates in LRYGB patients compared to LSG patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95192
Program Number: P146
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster