Laparoscopic Sleeve Gastrectomy has a Lower Risk of Postoperative Bleeding Than Laparoscopic Roux-en-Y Gastric Bypass
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
bariatric surgery; complications; obesity; outcomes; quality improvement
Measures to reduce postoperative bleeding (POB) after bariatric surgery is skewed toward laparoscopic sleeve gastrectomy (LSG). We use 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) to characterize the differences in bleeding rates between LSG and laparoscopic Roux-en-Y gastric bypasses (LRYGB). Propensity score matching and multivariable logistic regressions tested for independent differences in POB rates. A total of 168,093 patients from 742 centers were identified in the data set. After selection 36,925 patients with LRYGB and 20,020 patients with LSG were included in the analysis. A total of 710 (1.25%) patient suffered a POB. The independent odds of POB were 38% lower for patients having LSG compared with those having LRYGB (odds ratio, 0.62; 95% confidence interval=0.51-0.76). This difference is more pronounced with intraoperative securing of the staple line. Appropriate measures to reduce POB after each type of bariatric procedure is warranted.
Zafar, S., Shockcor, N., Prasad, N., Wise, E., Jackson, H., & Kligman, M. (2019). Laparoscopic Sleeve Gastrectomy has a Lower Risk of Postoperative Bleeding Than Laparoscopic Roux-en-Y Gastric Bypass. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, 29 (1). http://dx.doi.org/10.1097/SLE.0000000000000598