Background

The Bariatric Surgery field has grown and changed over the years, reflected in the implementation of different ERAS protocols and the increased number of MBSAQIP-accredited centers and fellowship-trained surgeons. Therefore, using the MBSAQIP database, this study aims to characterize the change in laparoscopic bariatric outcomes in early (ET) and late (LT) time intervals.

Methods

The MBSAQIP database was analyzed over ET (2015-2016) and LT (2019-2020) intervals. Patients who underwent initial laparoscopic SG and RYGB were identified. The cohorts were matched for 22 preoperative characteristics using propensity score matching analysis. We then compared 30-day outcomes and bariatric-specific complications between both time frames for SG and RYGB.

Results

158,994 and 59,440 match cohorts were obtained for ET and LT intervals in patients undergoing SG and RYGB, respectively. In both bariatric procedures, LT interval was associated with significantly lower rates of mortality, pulmonary complications, readmissions, reoperations, interventions, length of stay (LOS), postoperative bleeding, and strictures compared to ET interval. All of these variables achieved statistical significance (p<0.05) as shown in Table 1. In addition, LT interval showed lower rates of leak (0.2% vs 0.3%, p<0.001) and anastomotic ulcer (0.2% vs 0.3%, p=0.007) compared to ET interval in SG and RYGB patients, respectively.

Conclusions

There has been significant improvement in 30-day outcomes after bariatric surgery over time. Potential contributing factors include the ASMBS optimization programs in ERAS protocols, the increased number of fellowship-trained bariatric surgeons and MBSAQIP-accredited centers.