Complications of bariatric surgery – What the general surgeon needs to know

Ferraz

et al. 2018

Rev. Col. Bras. Cir.

Section: Discussionsupporting

confidence: 77%

Avaliação da qualidade de vida, perda de peso e comorbidades de pacientes submetidos à cirurgia bariátrica

Ferraz

et al. 2018

Rev. Col. Bras. Cir.

American Journal of Transplantation

“…Obesity is a well‐known risk factor for postoperative complications in elective general surgery including higher rates of pulmonary infection, wound dehiscence and infections, and thrombotic events . In addition, the length of hospital stay is prolonged for obese patients, and overall costs are significantly higher .…”

Section: Discussionmentioning

confidence: 99%

Donor BMI >30 Is Not a Contraindication for Live Liver Donation

Knaak

Goldaracena

Doyle

et al. 2017

The increased prevalence of obesity worldwide threatens the pool of living liver donors. Although the negative effects of graft steatosis on liver donation and transplantation are well known, the impact of obesity in the absence of hepatic steatosis on outcome of living donor liver transplantation (LDLT) is unknown. Consequently, we compared the outcome of LDLT using donors with BMI <30 versus donors with BMI ≥30. Between April 2000 and May 2014, 105 patients received a right-lobe liver graft from donors with BMI ≥30, whereas 364 recipients were transplanted with grafts from donors with BMI <30. Liver steatosis >10% was excluded in all donors with BMI >30 by imaging and liver biopsies. None of the donors had any other comorbidity. Donors with BMI <30 versus ≥30 had similar postoperative complication rates (Dindo-Clavien ≥3b: 2% vs. 3%; p = 0.71) and lengths of hospital stay (6 vs. 6 days; p = 0.13). Recipient graft function, assessed by posttransplant peak serum bilirubin and international normalized ratio was identical. Furthermore, no difference was observed in recipient complication rates (Dindo-Clavien ≥3b: 25% vs. 20%; p = 0.3) or lengths of hospital stay between groups. We concluded that donors with BMI ≥30, in the absence of graft steatosis, are not contraindicated for LDLT.

“…A recent systematic review and meta‐analysis concluded that overall complication rates associated with bariatric surgery range from 10% to 17% and reoperation rates approximately 7% . Other studies claim that these complication rates are much higher (up to 33%) and that the rates of longer term complications are largely unknown . A recent study that explored the rates of complications and ‘what a general surgeon needs to know’ suggested that band erosion can occur early or years after surgery and in some series the reported incidence rate is up to 33% .…”

Section: Discussionmentioning

confidence: 99%

Diverse approaches to the health economic evaluation of bariatric surgery: a comprehensive systematic review

et al. 2016

There is a need for studies that assume a broader societal perspective (including out-of-pocket costs, costs to family and productivity losses) and longer-term costs (capture reoperations/complications, waiting, body contouring), and consequences (health-related quality-of-life). Full economic evaluation underpinned by reporting standards should inform prioritization of patients (e.g. type 2 diabetes mellitus with body mass index 30 to 34.9 kg/m(2) or long-term waitlisted) for surgery. © 2016 World Obesity.