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Surgical Complications Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy in Patients Aged ? 65 Years from 2006-2016.

Rebekah Wood, BS1, Mukund Srinivas, BS1, Mike Bottomley, MS2, Priti Parikh, PhD1, Joon K Shim, MD, MPH, FACS1. 1Wright State University Boonshoft School of Medicine, 2Wright State University

INTRODUCTION: With the obesity epidemic in America, this study aimed to evaluate the outcomes of obese patients over the age of sixty-five after either laparoscopic/robotic Roux-En-Y or laparoscopic/robotic sleeve gastrectomy in one single tertiary institution. There are an increase number of patients over the age of sixty-five with indications for bariatric surgery. Studies have shown efficacy and safety of bariatric surgery in this age group.

METHODS: We retrospectively reviewed 70 laparoscopic/robotic Roux-En-Y gastric bypass and 74 laparoscopic/robotic sleeve gastrectomy that were performed on patients aged ≥ 65 years at a tertiary center from January 2006 to December 2016. Revisional surgeries were excluded. A logistical regression was run with ‘yes/no’ to ‘patient experienced a complication’ as the dependent variable. Demographic characteristics and perioperative data were analyzed including type of procedure, gender, smoking status, and BMI as independent variables. SAS version 9.4 (SAS Institute, Inc., Cary, NC) was used for analysis.

RESULTS: Tukey’s multiple comparison procedure adjusts the P-values to control for the number of comparisons made so that the experiment-wise type I error rate is held constant at alpha = 0.05.  The odds ratio estimate for laparoscopic/robotic Roux-En-Y gastric bypass is 3.183.  The adjusted 95% confidence interval for the true odds ratio is (1.082, 9.366). Based on the adjusted P-value of 0.03, there is strong evidence to suggest there is a significant difference in the odds of having a complication for patients who underwent laparoscopic/robotic Roux-En-Y gastric bypass versus patients who underwent laparoscopic/robotic gastric sleeve. There were a total of 32 patients who experienced a complication after laparoscopic/robotic Roux-En-Y gastric bypass. Eight of these 32 patients experienced more than 1 complication. There were a total of 17 patients who experienced a complication after laparoscopic gastric sleeve. No patients experienced multiple complications. Ulcer, perforation, surgical site infection, respiratory failure, acute kidney injury and bleeding were observed more frequently in laparoscopic/robotic Roux-En-Y gastric bypass. These complications were further categorized as short and long term complications.

CONCLUSION: For obese patients over the age of sixty-five, the odds of experiencing a complication postoperatively for patients undergoing laparoscopic/robotic Roux-En-Y gastric bypass were 3.183 times the odds of experiencing a complication postoperatively for patients undergoing a laparoscopic/robotic sleeve gastrectomy at our center. However, the 95% confidence interval indicates that the true odds ratio could be as low as 1.082 times more likely or as high as 9.366 times more likely in patients undergoing laparoscopic Roux-En-Y gastric bypass.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95063

Program Number: P099

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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