title: Early post-operative complications: incidence, management, and impact on length of hospital stay. A retrospective comparison between laparoscopic gastric bypass and sleeve gastrectomy.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common obesity surgeries. Their early complications may prolong hospital stay (HS).
  
  
  METHODS
  Data for patients who underwent LRYGB and LSG in our clinic from 2009 through August 2012 were collected. Early post-operative complications prolonging HS (>5 days) were retrospectively analyzed, highlighting their relative incidence, management, and impact on length of HS.
  
  
  RESULTS
  Sixty-six patients (4.9 %) after 1,345 LRYGB operations vs. 49 patients (7.14 %) after 686 LSG operations developed early complications. This difference is statistically significant (p = 0.039). Male gender percentage was significantly higher in complicated LSG group vs. complicated LRYGB group [23 patients (46.9 %) vs. 16 patients (24.2 %)] (p = 0.042). Mean BMI was significantly higher in the complicated LSG group (54.2 ± 8.3) vs. complicated LRYGB group (46.8 ± 5.7; p = 0.004). Median length of HS was not longer after complicated LSG compared with complicated LRYGB (11 vs. 10 days; p = 0.287). Leakage and bleeding were the most common complications after either procedure. Leakage rate was not higher after LSG (12 patients, 1.7 %) compared with LRYGB (22 patients, 1.6 %; p = 0.304). Bleeding rate was significantly higher after LSG (19 patients, 2.7 %) than after LRYGB (10 patients, 0.7 %; p = 0.004). Prolonged elevation of inflammatory markers was the most common presentation for complications after LSG (18 patients, 36.7 %) and LRYGB (31 patients, 46.9 %).
  
  
  CONCLUSIONS
  LSG was associated with more early complications. This may be attributed to higher BMI and predominance of males in LSG group.
authors.affiliation: Surgery Department, Sachsenhausen Hospital, Krankenhaus Sachsenhausen Schulstr. 31, 60594, Frankfurt am Main, Germany, rweiner@khs-ffm.de.
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: Weiner
authors.forename: Islam A
authors.initials: IA
authors.lastname: El-Sayes
authors.forename: Sophia
authors.initials: S
authors.lastname: Theodoridou
authors.forename: Sylvia R
authors.initials: SR
authors.lastname: Weiner
authors.forename: Oliver
authors.initials: O
authors.lastname: Scheffel
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006470:Hemorrhage; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome