Background

The risk of postoperative mortality after metabolic and bariatric surgery (MBS) is often considered to be too high for individuals with Prader-Willi Syndrome (PWS) ObjectivesDetermine the rate of postoperative mortality following initial MBS for the treatment of obesity in PWS.

Methods

A systematic review of articles in the English language of MBS in PWS was performed using PubMed, Embase and Cochrane Central identifying 254 citations extending from 1974 to July 2022. Twenty-eight articles in the English language were identified that reported on a total of 103 patients having a primary MBS operation.

Results

There were 3 deaths reported within 12 months following 103 MBS operations performed for obesity on PWS individuals for a postoperative mortality rate of 2.9%. Two reported in 1985 following a jejunoileal bypass which is no longer performed, and one reported in 1996 following a gastric band placement. There has been no postoperative mortality recorded in the 71 individuals with PWS that had MBS since 1996. No postoperative mortality was reported any of the individuals with PWS (87) that had a primary laparoscopic gastric sleeve (n=34), gastric bypass (n=23) or biliopancreatic diversion with or without duodenal switch (n=30).

Conclusions

There has been no postoperative mortality reported in a primary laparoscopic gastric sleeve, gastric bypass or biliopancreatic bypass with or without a duodenal switch. Therefore, individuals with PWS who suffer from severe obesity should not be excluded from being evaluated for MBS.