Background

With the rapid proliferation of effective weight-loss medications, it is increasingly important to understand the safety of bariatric surgery. Our aim was to compare adverse outcomes of bariatric surgery with those of the most common surgical procedures in the United States.

Methods

The 2021 ACS-NSQIP data registry was utilized to compare 30-day adverse outcomes of elective bariatric vs non-bariatric surgical procedures. We used a 1:1 propensity score based on age, ASA, BMI, and comorbidities to match patients. We then created three risk profile groups (low, intermediate, and high) based on perioperative outcomes of bariatric and non-bariatric surgical procedures.

Results

292,811 elective bariatric and non-bariatric cases were analyzed (Table 1). We divided these procedures into three groups (low, intermediate, and high risks) based on their complication rates (Figure 1). Laparoscopic sleeve gastrectomy is among the lowest for major complications, reoperation and readmission rates. Laparoscopic gastric bypass compares favorably to laparoscopic appendectomy and laparoscopic cholecystectomy with or without intrao-operative cholagiogram for major complications, although reoperation and readmission rates are higher.

Conclusions

When compared to the most common surgical procedures, our study demonstrates bariatric procedures had less complications overall with more patients going directly home immediately following discharge. It is important that patients and referring physicians understand that the safety of bariatric surgery compares favorably with many common surgical procedures.