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Surg Endosc. 2004 Feb;18(2):193-7. Epub 2003 Dec 29.

Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality.

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1
Department of Surgery, Virginia Commonwealth University, Post Office Box 980428, Richmond, VA 23298, USA.

Abstract

BACKGROUND:

Intestinal leak is a potentially lethal complication of Roux en-Y gastric bypass (GBP). Identification of patients at high risk for leak may reduce complication rates of surgeons early in the procedure learning curve.

METHODS:

A total of 3073 patients who underwent GBP were analyzed using univariate and multivariate logistic regression analyses of the following preoperative factors: hypertension (HTN), diabetes mellitus (DM), sleep apnea (SA), age, gender, weight, body mass index (BMI), and surgery type. Multivariate logistic regression analysis was performed for each procedure type.

RESULTS:

There were 48 (1.5%) deaths. Independent risk factors for death included leak, weight, procedure type, and HTN. A total of 102 (3.2%) leaks were found. Independent factors for leak included age, male gender, SA, and procedure type.

CONCLUSION:

The data suggests that older, heavier male patients with multiple comorbid conditions are at increased risk for leak and mortality. Surgeons early in their learning curve should avoid these high-risk patients to reduce complications.

PMID:
14691697
DOI:
10.1007/s00464-003-8926-y
[Indexed for MEDLINE]

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