Timing of Reoperation after Sleeve Gastrectomy: An Important Metric to Identify Criteria for Safe Same-Day Operation

Document Type

Conference Proceeding

Publication Date

11-1-2023

Publication Title

J Am Coll Surg

Abstract

Introduction: Early reoperation after sleeve gastrectomy (SG) is an adverse event that may increase the risk of perioperative mortality if there is a delay in care. However, it is unclear what proportion of reoperation occurs within 24 hours of SG and who is at higher risk, which may impact the safety of performing same-day operation. Methods: Using a statewide bariatric surgery data registry, patients undergoing primary SG cases were analyzed (n = 42,633). Patients who had a subsequent reoperation were identified and reasons for reoperation were compared between those occurring <24 hours vs >24 hours. In addition, patients who underwent a reoperation <24 hours were compared with patients who underwent primary SG and did not experience any complication. Results: A total of 314 (0.74%) patients required reoperation after primary SG and 31% (n = 98) of reoperation occurred in <24 hours, with the most common reason being hemorrhage (88%). Patients who underwent reoperation <24 hours were older, (49 years vs 44 years; p = 0.0001), more likely to be men (32.6% vs 19.9%; p = 0.0016), had higher rate of hypertension (69.4% vs 47.2%; p < 0.0001), liver disease (26.5% vs 14.1%; p = 0.0004); sleep apnea (64.3% vs 46.2%; p < 0.0003), and a history of preoperative venous thromboembolism (10.2% vs 4.5 %; p = 0.0062), when compared with patients who underwent SG without complication. Conclusion: Reoperation after primary SG is rare but occurs within 24 hours in approximately 1/3rd of cases. Older male patients with significant comorbidity are at increased risk for an early, life-threatening event and should be considered poor candidates for same-day operation.

Volume

237

Issue

5

First Page

S31

Last Page

S32

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