Key result
Obese patients undergoing bariatric surgery had significantly higher rates of minor complications compared to non-bariatric patients undergoing cholecystectomy (20.8% vs. 5.1%, p<0.001).
Why the study?
Altered physiology and metabolism of obese patients challenge anesthesiologists, motivating an evaluation of comorbidities, anesthesia technique choices, and complications compared with non-bariatric patients.
Does bariatric surgery in obese patients compared to laparoscopic cholecystectomy in non-bariatric patients increase the risk of intraoperative and postoperative complications?
Observational (n=469)
No
Does bariatric surgery in obese patients compared to laparoscopic cholecystectomy in non-bariatric patients increase the risk of intraoperative and postoperative complications?
Absolute Event Rate: 20.8% vs 5.1%
p-value: p=<0.001
Obese patients undergoing bariatric surgery present with more comorbidities and experience more minor intraoperative and postoperative complications than non-bariatric patients, though major complications do not differ.
Heightened perioperative vigilance may be warranted in bariatric surgery; this cohort study leaves open causality amid higher baseline comorbidities.
Introduction/Objective. Altered physiology and metabolism of obese patients represents a big challenge for the anesthesiologist. The objectives of the study are to investigate numbers of comorbidities, choice of anesthesia techniques, intraoperative, and postoperative complications between bariatric and non-bariatric patients. Methods. This retrospective study included 469 patients. The study group of patients included obese patients with body mass index ? 30. Control Group included patients in whom elective laparoscopic cholecystectomy was performed, on the same day as bariatric surgery in Control Group. Results. The study group included 235 patients who underwent bariatric surgery, while control group included 234 patients. More patients in study group had comorbidities compared with Control Group (84.4% vs. 63.2%, p < 0.001). In the study group, total intravenous anesthesia and target control anesthesia were statistically significant more delivered than in the Control Group (74% vs. 0.9%, p < 0.001; 7.2% vs. 1.7, p < 0.001, respectively). Difficult intubation was statistically significant more in Control Group (5.6% vs. 0.9%, p = 0.004). There was a statistically significant difference in the incidence of intraoperative desaturation and hypotension during induction of anesthesia between the study and Control Group (9.8% vs. 2.1%, p < 0.001; 14.5% vs. 2.1, p < 0.001, respectively). There was statistically significant difference between the study and control group in minor complication according Clavien?Dindo classification, (20.8% vs. 5.1%, p < 0.001). Conclusion. Obesity is associated with higher number of comorbidities and intraoperative complications. There was no statistically difference in major postoperative complications between bariatric and non-bariatric patients.
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Palibrk et al. (2024) conducted an observational in Obesity (n=469). Bariatric surgery (obesity) vs. Elective laparoscopic cholecystectomy was evaluated on Minor complications according to Clavien-Dindo classification (p=<0.001). Obese patients undergoing bariatric surgery had significantly higher rates of minor complications compared to non-bariatric patients undergoing cholecystectomy (20.8% vs. 5.1%, p<0.001).
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