Mild elevation of fasting plasma glucose is a strong risk factor for postoperative complications in gastric bypass patients.
BACKGROUND
Bariatric surgery may be associated with surgical complications. The aim of the study was to identify significant risk factors for postoperative complications in patients undergoing Roux-en-Y gastric bypass (RYGBP).


METHODS
The study consisted of 75 consecutive patients undergoing RYGBP. Full medical examination was performed, and the following parameters were assessed in the fasting state: plasma glucose, insulin, leptin, serum lipids, liver function tests, and lipoprotein Lp(a). All subjects had oral 75 g glucose tolerance test before the surgery. All complications occurring within 6 months after the RYGBP were recorded. The patients were divided into Group 1 - patients in whom complications occurred, and Group 2 - patients with no complications in the 6-month period.


RESULTS
Postoperative complications occurred in 16 patients (wound infection, hernia, splenic injury, gastro-jejunal obstruction, duodenal ulcer, lower limb deep vein thrombosis). 3 significant risk factors for postoperative complications within 6 months after gastric bypass were found: 1) fasting plasma glucose >/= 6.0 mmol/l (OR 11.0; 95% confidence interval (CI) 2.1-77.3), 2) age >/=40 years (OR 5.89, 95% CI 1.35-29.4), and 3) BMI >/=45 kg/m(2) (OR 4.1, 95% CI 1.04-17.2).


CONCLUSIONS
RYGBP is associated with increased risk of developing early postoperative complications in subjects with even slightly elevated fasting plasma glucose, age >/=40 and BMI >/=45 kg/m(2).
Czupryniak
Leszek
L
Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland. leszek.czupryniak@dtu.ox.ac.uk
Strzelczyk
Janusz
J
Pawlowski
Maciej
M
Loba
Jerzy
J
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D005951:Glucose Tolerance Test; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D018709:Statistics, Nonparametric
D015415:Biomarkers; D001786:Blood Glucose