Comparing outcomes of laparoscopic versus open bariatric surgery.
OBJECTIVE
The objective of this study was to use nationally representative data to compare outcomes of open gastric bypass (OGB) versus laparoscopic gastric bypass (LGB) surgery.


BACKGROUND
The number of bariatric procedures continues to grow. Increasingly, these surgeries are being performed laparoscopically. However, few population-based studies have examined differences in outcomes between LGB and OGB surgeries. Population-based studies can provide further insight into differences in outcomes between open and laparoscopic bariatric procedures.


METHODS
Using the Nationwide Inpatient Sample, we identified adults undergoing LGB or OGB surgery during 2005 (n = 19,156). Following preliminary descriptive statistics, multiple logistic and linear regressions were used to obtain risk-adjusted outcomes, including postoperative in-hospital complications, reoperation, length of stay, and total charges.


RESULTS
The majority of patients in the study sample (74.5%) underwent laparoscopic bypass surgery in 2005. After adjusting for patient and hospital level factors, patients undergoing OGB surgery were more likely to experience reoperation as well as the following complications: pulmonary (odds ratio [OR] = 1.92 (1.54-2.38), P < 0.001); cardiovascular (OR = 1.54 [1.07-2.23], P = 0.02); procedural (OR = 1.29 [1.06-1.57], P < 0.01); sepsis (OR = 2.18 [1.50-3.16], P < 0.001); and anastomotic leak (OR = 1.32 [1.02-1.71], P = 0.03). After risk adjustment, LGB was associated with a shorter length of stay but higher total charges.


CONCLUSIONS
Overall, LGB patients are less likely to experience reoperation and postoperative complications in the hospital and have a shorter length of stay but incur higher total charges than OGB patients.
Weller
Wendy E
WE
Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York, University at Albany, Rensselaer, NY 12144-3456, USA. wweller@albany.edu
Rosati
Carl
C
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015390:Gastric Bypass / Q000191:economics / Q000379:methods*; D017722:Hospital Charges; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology