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Comparative Study
. 2019 Jul;23(7):1362-1372.
doi: 10.1007/s11605-018-3951-2. Epub 2019 Apr 22.

Trends in Utilization and Relative Complication Rates of Bariatric Procedures

Ann Y Chung  1 , Paula D Strassle  2 , Francisco Schlottmann  2 , Marco G Patti  2 , Meredith C Duke  2 , Timothy M Farrell  2
Affiliations
Comparative Study

Trends in Utilization and Relative Complication Rates of Bariatric Procedures

Ann Y Chung et al. J Gastrointest Surg. 2019 Jul.

Abstract

Background: Laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding have been popular alternatives to laparoscopic Roux-en-Y gastric bypass due to their technical ease and lower complication rates. Comprehensive longitudinal data are necessary to guide selection of the appropriate bariatric procedures for individual patients.

Methods: We used the Truven Heath Analytics MarketScan® database between 2000 and 2015 to identify patients undergoing bariatric surgery. Kaplan-Meier and Cox proportional hazard regression analyses were performed to compare complication rates between laparoscopic gastric bypass and laparoscopic sleeve gastrectomy, as well as between laparoscopic gastric bypass and laparoscopic adjustable gastric banding.

Results: 256,830 individuals met search criteria. By 2015, laparoscopic sleeve gastrectomy was the most commonly performed bariatric procedure followed by laparoscopic gastric bypass and then laparoscopic adjustable gastric banding. Overall, laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding had fewer complications relative to laparoscopic gastric bypass with the exceptions of heartburn, gastritis, and portal vein thrombosis following sleeve gastrectomy and heartburn and dysphagia following adjustable gastric banding.

Conclusion: Laparoscopic sleeve gastrectomy is now the most commonly performed bariatric procedure in the USA. It is reassuring that its overall postoperative complication rates are lower relative to laparoscopic gastric bypass.

Keywords: Bariatric surgery; Complications of bariatric surgery; Gastric banding; Gastric bypass; Sleeve gastrectomy.

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