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

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 fo

Contact: Tamara Hargens
JAMA and Archives Journals

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