Background

The sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the predominant bariatric procedures in the U.S. and each exhibit respective weight loss and comorbidity resolution rates, however RYGB carries a moderately higher risk of postoperative complications. We sought to compare the frequency of postoperative Emergency department (ED) visits and CT scans in patients undergoing SG and RYGB.

Methods

We performed a retrospective review of a prospectively maintained database of adult patients who underwent primary SG or RYGB at an Accredited Bariatric Program between 2015 and 2019. Bivariate comparisons between groups (GB vs SG) were conducted using the Chi-square test for categorical data and Students t-test for continuous data. P-values < 0.05 were considered significant.

Results

Of the 1624 total patients, the average age was 44 years, 84% were female, 71% were white, and the average preoperative BMI was 46 kg/m2. Operations performed included RYGB (926 cases, 57%) and SG (698 cases, 43%). Within the 30-day postoperative window, 174 patients (11%) presented to the ED, and were more often RYGB than SG patients (12.3% vs 8.6%, p = 0.017). A CT scan was obtained in 49% of ED presentations, again more frequently for RYGB than SG patients (6.1% vs 3.9%, p = 0.048).

Conclusions

Patients with RYGB undergo more postoperative CT scans than SG patients. The increased radiation exposure is considerable in the bariatric patient, and the potential cancer risk should be included in preoperative counseling when discussing RYGB vs SG.