Background

As the geriatric bariatric population grows, more patients may require elective revisional bariatric surgery (MBS). Revisional MBS has a known high complication rate; however, the risk is presumed higher in geriatric patients. This abstract presents the first outcomes of elective revisional MBS in patients aged >= 70.

Methods

Single-center retrospective cohort study from 2012 to 2022 of patients ages >= 70 who underwent elective revisional MBS (GRB). Revisional MBS were categorized as conversion operations (vertical banded gastroplasty to roux-en-y gastric bypass (RYGB), or RYGB to duodenal switch), augmentation (type 1 distalization), corrective operations (revisions of gastrojejunostomy or esophagojejunostomy), or reversal of RYGB. Outcomes are compared to our extrapolated cohort of revisional MBS (RB) patients aged 45-65 and a geriatric cohort of bariatric patients ages >70 (GP) undergoing laparoscopic RYGB and SG.

Results

51 patients, mean age 73.4 (range 70-88), 82% female. Extrapolated cohort of 1205 RB patients and 130 GP patients. Our GRB 30-day postoperative readmission rate was 3.9% vs RB 12.4 % (p=0.034) vs GP 5.3% (p=0.35). 30-day reoperation rates were GRB 9.8% vs RB 6.1% (p=0.146) vs GP 3.1% (p=0.030). 30-day postoperative complication rate was 15.7% versus RB 12.0% (p=0.217) GP 9.2% (p= 0.103) with no 30-day mortality. All-cause mortality rate was 7.8%. More complications were seen in the corrective operations group (Table 1).

Conclusions

Revisional MBS in patients age >= 70 had lower readmission rates but not significantly higher complication rate than younger patients undergoing revisional MBS. Revisional MBS can be safely performed in septuagenarians and octogenarians.