title: Bariatric surgery trends in France: 2005-2011.
abstract: BACKGROUND
  Bariatric surgery underwent a dramatic change in the past decade in France. The objective of this study was to examine elective bariatric surgical procedures from 2005 to 2011 in France and to determine trends in the use of the procedure.
  
  
  METHODS
  Data were extracted from the National Hospital Database. All admissions involving a bariatric surgery procedure were included. Procedures authorized by the Public Health Authority for the treatment of morbid obesity, including the adjustable gastric banding (AGB), vertical banded gastroplasty (VBG), gastric bypass (GB), sleeve gastrectomy (SG), and biliopancreatic diversion (BPD), either by laparotomic or laparoscopic approach, were retrieved. Revisional procedures, such as band removal or repositioning, band changing, and access device revisions, were also evaluated.
  
  
  RESULTS
  We observed a 2.5-fold increase in bariatric procedures, from 12,800 in 2005 to 31,000 in 2011. Sleeve gastrectomy and gastric bypass became the most common bariatric procedures in France in 2011, whereas adjustable gastric banding has been decreasing since 2007. During the analysis period, about 50,000 revisional procedures were performed. The number of hospitals (private or public) providing bariatric surgery has considerably increased. However, most of the activity remains confined to a small number of centers, as 50% of all bariatric surgeries are carried out in 12% of hospitals. Bariatric procedures are predominantly performed in private hospitals.
  
  
  CONCLUSIONS
  In France the number of bariatric procedures increased considerably between 2005 and 2011. The type of procedures changed, with a constant decrease of AGB and an important increase of SG and GB. Most bariatric procedures are still performed in low volume activity hospitals and in private hospitals.
authors.affiliation: Department of Digestive, HepatoPancreatoBiliary, and Liver Transplantation Surgery, Créteil, France. Electronic address: andrea.lazzati@hmn.aphp.fr.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lazzati
authors.affiliation: Ethicon Endo Surgery, Issy-les-Moulineaux, France.
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Guy-Lachuer
authors.affiliation: Ethicon Endo Surgery, Issy-les-Moulineaux, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Delaunay
authors.affiliation: Ethicon Endo Surgery, Issy-les-Moulineaux, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Szwarcensztein
authors.affiliation: Department of Digestive, HepatoPancreatoBiliary, and Liver Transplantation Surgery, Créteil, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D005602:France / Q000453:epidemiology; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Adjustable gastric banding; Bariatric surgery; France; Gastric bypass; Sleeve gastrectomy; Trends