Long-term incidence of bariatric related procedures following laparoscopic gastric bypass: 15 to 20 years single institution experience

Background

Long-term data on the likelihood of undergoing additional related operations after Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) remain scarce.

Objectives

The aims of this study are to identify the long-term incidence of bariatric related operations, patient’s predictive factors, and most common operations in the 15–20 years following LRYGB.

Setting

Single Academic Institution, Center of Bariatric Excellence.

Methods

We performed a retrospective analysis of all LRYGB performed at Single Institution from 2003 to 2008. All subsequent bariatric related operations performed were manually reviewed, excluding upper endoscopies. Kaplan–Meier analysis was utilized to estimate the time to procedure. Cox regression was used to determine patient’s factors associated with time until procedure.

Results

Of the 665 patients included, the median follow-up was 14 years. There were 248 (37.3%) patients with a related operation. After excluding panniculectomy, 199 (29.9%) had a related operation. The 3 most common operations were panniculectomy [n = 77 (12%)], followed by cholecystectomy [n = 64 (10%)], and internal hernia repair [n = 56 (8%)]. The Kaplan–Meier estimated incidence of related operation at 15 years was 43.7% and 35.3% after excluding panniculectomy. Females (HR = 1.77, 95% CI = [1.20, 2.62, p = 0.0039), age < 50 (HR = 1.42, 95% CI = [1.07, 1.88], p = 0.014), and BMI > 60 (HR = 2.77, 95% CI = [1.30, 5.91], p = 0.0083) were more likely to have a related operation.

Conclusion

Bariatric related operations are common after LRYGB. Nearly half of patients will eventually undergo a secondary operation as they approach 20 years post-LRYGB.