Shravan Leonard-Murali Hassan Nasser Tommy Ivanics Dania Shakaroun Jeffrey A. Genaw
Henry Ford Health System
Introduction: The safety and efficacy of laparoscopic sleeve gastrectomy (LSG) and roux-en-Y gastric bypass (RYGB) for the treatment of obesity and associated comorbidities, including type 2 diabetes ..
Introduction: The safety and efficacy of laparoscopic sleeve gastrectomy (LSG) and roux-en-Y gastric bypass (RYGB) for the treatment of obesity and associated comorbidities, including type 2 diabetes mellitus (T2DM), is well established. However, these comorbidities may add risk to the perioperative period. We sought to characterize perioperative outcomes of these surgical procedures in type 2 diabetics using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, and further analyze diabetic patients based on their insulin dependence.Methods: All patients undergoing LSG and LRYGB between the years 2015 and 2017 in the MBSAQIP database were identified. Patients were divided into three groups: non-diabetics (NDM), non-insulin dependent type 2 diabetics (NIDDM), and insulin dependent type 2 diabetics (IDDM). Primary outcomes included serious adverse events, 30-day readmission, 30-day reoperation, and 30-day mortality. Secondary outcomes included length of stay, renal events, cardiac events, respiratory complications, surgical site infections, septic events, urinary tract infections, venous thromboembolism, perioperative transfusions, and reinterventions. These were compared between the groups using Pearson chi square test or Fisher’s exact test as appropriate. Multivariate logistic regression was then used to adjust for demographics, co-morbidities, and operative variables, with adjusted odds ratio (AOR) reported for each outcome. This was done with the NDM group as reference for the diabetic groups, and then with the NIDDM group as reference for the IDDM group. Significance was established at p