Background

Though bariatric surgery perioperative complications are rare and recoverable, the impact of these complications on one-year weight loss is not well characterized.

Methods

This is a retrospective analysis of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) at a large academic center between 2017 and 2019. Weight and complication data was extracted from our institution's Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Patients without one-year weight outcomes, or who were undergoing a revision procedure were excluded.

Results

44 RYGB and 189 LSG were included in this study. Of the 35 patients with complications, 11 had a undergone LRGYB. Compared to those without complications, patients with complications had lower preoperative BMI (37.6 versus 47.6; p<0.0001), longer length of stay (2.2 versus 1.8 days; p=0.03), and lower one-year %Total Body Weight Loss (TBW) (5.5% versus 24%, p<0.01). The most common complications were dehydration (n=9), transfusion (6), and surgical site infection (4). Receiving postoperative transfusions was associated with the lowest one-year %TBW (-7.4%). 17 patients were readmitted, most commonly for nausea (5), sepsis (3), or pain (2). Complications were associated with a lower one-year %TBW in patients after LSG compared to RYGB (0.5% versus 22.9% one-year %TWL, p<0.01).

Conclusions

These results suggest perioperative complications may have lasting impacts on postoperative weight loss, especially after LSG. Patients known to have complications after surgery may benefit from closer follow-up to ensure appropriate post-operative weight loss. Longer term studies may be indicated.