Early complications, long-term adverse events, and quality of life after duodenal switch and gastric bypass in a matched national cohort.

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
Martin L Skogar, Magnus Sundbom

Abstract

Insufficient weight loss is common in super-obese patients (body mass index >50) after Roux-en-Y gastric bypass (RYGB). Duodenal switch (DS) is more effective; however, it is considered to have an increased complication rate. To compare early complications (≤30 d), long-term adverse events, and quality of life (QoL) between primary DS and RYGB. Sweden. National cohort-study of super-obese patients after primary DS or RYGB in Sweden 2007 to 2017. Propensity-score matching was used to reduce confounders. Five national registers were cross-matched. The study population consisted of 333 DS and 1332 RYGB (body mass index 55 ± 5 kg/m2, 38.5 ± 11 yr, and 60.7% females). Laparoscopic approach was used in 25% of DS and 91% of RYGB. Early complications were more common after DS (15.3% versus 8.1%, P < .01), mainly because of more open surgery and related surgical site infections. During 4.6 ± 2.3 years mean follow-up, hospital admission rate was 1.4 ± 2.3 versus 1.1 ± 3.3 (P = .18), with 6.7 ± 18.3 versus 7.0 ± 43.0 in-hospital days, for DS and RYGB, respectively. An increased risk of malnutrition/malabsorption requiring inpatient care (2.8% versus .2%, odds ratio 12.3 [3.3-45.7]) and greater need for additional abdominal surgery (25.8% ...Continue Reading

Citations

Oct 1, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Saketh R VelapatiManpreet S Mundi
Jul 1, 2020·Gastrointestinal Endoscopy·Mohamad Kareem MarracheVivek Kumbhari
Jun 22, 2021·Current Opinion in Clinical Nutrition and Metabolic Care·Osman Mohamed ElfadilManpreet S Mundi
Oct 12, 2021·Obesity Surgery·Piotr MałczakMichał Pędziwiatr

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