The prevalence has increased dramatically, and complications may be more common than previously reported.
Two studies provide new data on the frequency of bariatric surgery and its complications in the U.S.
Using the National Hospital Discharge Survey (an annual probability sample of discharged patients), researchers estimated that the prevalence of gastric bypass surgery increased from about 14,000 procedures in 1998 to about 83,000 in 2002. About 80% of the procedures were performed in women.
In another study, researchers determined complication rates among 2522 patients (85% women) who underwent bariatric surgery (mostly bypass procedures) in 2001 and 2002; data came from a nationwide insurance claims database covering nearly 6 million privately insured people under age 65. Complication rates were 22% during the initial hospitalization and rose to 40% during 6 months of follow-up. The most common complications were a composite of gastrointestinal symptoms including vomiting, diarrhea, dysphagia, and reflux (20%), anastomotic problems (12%), abdominal hernia (7%), and "infections" (6%). About 7% of patients were readmitted to the hospital within 6 months to treat complications specific to the bariatric procedure. Six-month mortality was 0.2%.
Comment: The increase in bariatric surgery in recent years has been explosive. The second study suggests a higher rate of complications than has been reported in some smaller single-center studies, possibly because it represents a broader range of surgical expertise.
— Allan S. Brett, MD
Citation(s):
Smoot TM et al. Gastric bypass surgery in the United States, 1998-2002. Am J Public Health 2006 Jul; 96:1187-9.