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Background <p>Understanding mortality risk following bariatric surgery is crucial for clinical decision-making as these procedures increase globally.</p> Objectives <p>To analyze current evidence regarding perioperative, intermediate, and long-term mortality following bariatric surgery across different techniques and patient populations.</p> Methods <p>Systematic literature search in PubMed, Embase, and Cochrane databases (2015–2025) for studies reporting mortality after bariatric surgery. Large-scale registries, meta-analyses, and long-term follow-up studies were prioritized.</p> Results <p>Among 42 studies meeting inclusion criteria (&gt; 1.2 million procedures), perioperative mortality (≤ 30&#xa0;days) was 0.08% (95% CI, 0.06–0.11%) for primary procedures. Procedure-specific mortality: sleeve gastrectomy (0.03–0.08%), adjustable gastric banding (0.01–0.05%), Roux-en-Y gastric bypass (0.07–0.2%), and biliopancreatic diversion (0.2–0.5%). Revisional surgery carried higher risk (0.3–0.5%). Long-term all-cause mortality was 30–50% lower among bariatric surgery patients versus non-surgical controls (HR 0.45–0.75). Cardiovascular mortality reduction was most pronounced (HR 0.47, 95% CI 0.36–0.62). Risk factors for increased mortality included age &gt; 65&#xa0;years, male sex, BMI &gt; 50&#xa0;kg/m<sup>2</sup>, significant comorbidities, and low-volume centers.</p> Conclusion <p>Modern bariatric surgery demonstrates remarkably low perioperative mortality, particularly for primary procedures in experienced centers. Long-term survival benefits substantially outweigh early risks in appropriately selected patients. Further research should focus on risk mitigation in highest-risk populations and global standardization of safety protocols.</p>

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Mortality After Bariatric Surgery: A Comprehensive Review

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Nozim Jumaev,
  • Oktyabr Teshaev,
  • Baxodir Tavasharov,
  • Munazzafa Lekomseva

摘要

Background

Understanding mortality risk following bariatric surgery is crucial for clinical decision-making as these procedures increase globally.

Objectives

To analyze current evidence regarding perioperative, intermediate, and long-term mortality following bariatric surgery across different techniques and patient populations.

Methods

Systematic literature search in PubMed, Embase, and Cochrane databases (2015–2025) for studies reporting mortality after bariatric surgery. Large-scale registries, meta-analyses, and long-term follow-up studies were prioritized.

Results

Among 42 studies meeting inclusion criteria (> 1.2 million procedures), perioperative mortality (≤ 30 days) was 0.08% (95% CI, 0.06–0.11%) for primary procedures. Procedure-specific mortality: sleeve gastrectomy (0.03–0.08%), adjustable gastric banding (0.01–0.05%), Roux-en-Y gastric bypass (0.07–0.2%), and biliopancreatic diversion (0.2–0.5%). Revisional surgery carried higher risk (0.3–0.5%). Long-term all-cause mortality was 30–50% lower among bariatric surgery patients versus non-surgical controls (HR 0.45–0.75). Cardiovascular mortality reduction was most pronounced (HR 0.47, 95% CI 0.36–0.62). Risk factors for increased mortality included age > 65 years, male sex, BMI > 50 kg/m2, significant comorbidities, and low-volume centers.

Conclusion

Modern bariatric surgery demonstrates remarkably low perioperative mortality, particularly for primary procedures in experienced centers. Long-term survival benefits substantially outweigh early risks in appropriately selected patients. Further research should focus on risk mitigation in highest-risk populations and global standardization of safety protocols.