Increased age, certain procedures associated with increased complications after bariatric surgery

March 20, 2006

Older patients and those who undergo a certain type of procedure known as duodenal switch have an increased number of complications following bariatric surgery, according to a study in the March issue of Archives of Surgery, one of the JAMA/Archives journals.

In response to the increasing prevalence of obesity, the number of bariatric surgeries performed to induce weight loss has risen dramatically, according to background information in the first article. These procedures are technically demanding and performed on patients whose obesity and related conditions may put them at risk for complications after surgery. Therefore, it is important to understand risk factors that may influence risk, including body mass index (BMI), age, other illnesses and choice of procedure, the authors write.

Robert W. O'Rourke, M.D., and colleagues at the Oregon Health & Science University, Portland, reviewed data from 452 patients (372 women and 80 men, average age 44 years) undergoing inpatient bariatric procedures at the university between 2000 and 2003. The patients received either gastric bypass surgery, which involves sectioning off a small portion of the stomach into a pouch that connects directly to the small intestine, or biliopancreatic diversion with duodenal switch, a less commonly used procedure in which surgeons remove part of stomach but leave a slightly larger pouch and then also perform an intestinal bypass-like procedure by attaching the duodenum (the first part of the small intestine) to the lower part of the small intestine. Researchers examined several variables, including patients' age, BMI (calculated by dividing their weights by the square of their heights), gender, surgeon experience, other illnesses, type of procedure and whether they underwent open or laparoscopic (minimally invasive) surgery.

Participants lost an average of 54 percent of their excess weight in the year following surgery. During the study, which followed patients for an average of 419 days, four (.9 percent) died, 10 percent had major complications and 13 percent had minor complications. Patients who were age 60 years or older were more likely to develop complications than younger patients, a risk that appeared to increase with each additional year. The duodenal switch procedure was also associated with more complications than gastric bypass surgery. BMI, sex, diabetes, surgical approach (open vs. laparoscopic) and surgeon experience did not appear to be associated with increased risk for complications.

The findings suggest that surgeons should warn older adults and those considering duodenal switch procedures of the risks involved, the authors write. "While some investigators have suggested a specific age limit as an absolute contraindication to bariatric surgery, we do not employ such limits for our patients," they write. "We nevertheless approach older patients with caution, especially in light of recent data that suggest that the benefits of bariatric surgery with respect to longevity may wane in older patients."
-end-
(Arch Surg. 2006;141:262-268. Available pre-embargo to the media at www.jamamedia.org.)

The JAMA Network Journals

Related Bariatric Surgery Articles from Brightsurf:

Statement on metabolic and bariatric surgery during COVID-19 pandemic
The American Society for Metabolic and Bariatric Surgery (ASMBS), the leading organization of bariatric surgeons and integrated health professionals in the nation, declared metabolic and bariatric surgery 'medically necessary and the best treatment for those with the life-threatening and life-limiting disease of severe obesity' and called for the safe and rapid resumption of procedures, which have been largely postponed along with other surgeries deemed elective amid the COVID-19 pandemic.

Examining association between weight loss before bariatric surgery, risk of death after surgery
Researchers looked at whether a patient's body weight and weight loss before bariatric surgery were associated with risk of death within 30 days after surgery using data from nearly 500,000 patients in the US and Canada.

Bariatric surgery effective against early-onset obesity too
Surgical treatment of obesity is as effective for individuals who developed the disorder early, by the age of 20, as for those who have developed obesity later in life, a study from the University of Gothenburg shows.

Lower risk for malignant melanoma after bariatric surgery
Bariatric surgery is associated with a distinct reduction in skin-cancer risk, a study shows.

Study shows risks for additional procedures after bariatric surgery
Which of the two most common bariatric surgeries -- gastric sleeve or gastric bypass -- has the highest subsequent risk of additional operations or procedures?

Studies continue to highlight benefits of bariatric surgery in teens
Children's Colorado researchers and their colleagues found that musculoskeletal pain, physical function and quality of life in adolescents significantly improves and is maintained three years after bariatric surgery.

Bariatric surgery may not lead to lower health care costs
Despite helping to bring about improved survival and significant weight loss, bariatric surgery may not lead to lower health care costs in the long term, says a Veterans Affairs study.

Bariatric surgery is safe for teens with morbid obesity
Bariatric surgery is safe and, in many cases, beneficial for teenagers with morbid obesity who would otherwise face a heightened risk of developing severe health problems, including heart disease and stroke, according to a new study from Penn Medicine and the Children's Hospital of Philadelphia (CHOP).

Criteria for bariatric surgery should consider more than just patient's weight
More than one-third of Americans are obese, and while more than 250,000 bariatric surgeries are performed annually in the United States, experts at The Ohio State University Wexner Medical Center and 45 worldwide scientific and medical societies say surgery should be an option for many more patients.

Bariatric surgery can be safe and effective for adolescents
Pediatricians are often reluctant to recommend bariatric surgery for teen-agers, but a Rutgers-led study concludes it is a justifiable treatment for adolescents with persistent extreme obesity if they can maintain a healthy lifestyle afterward.

Read More: Bariatric Surgery News and Bariatric Surgery Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.