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Comparing Outcomes of Laparoscopic Versus Open Bariatric Surgery

Weller, Wendy E. PhD*; Rosati, Carl MD, FRCSC

doi: 10.1097/SLA.0b013e31816d953a

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.

Conclusion: 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.

This study uses nationally representative, population-based data to examine outcomes of laparoscopic versus gastric bypass surgery.

From the *Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York, University at Albany; and †Sections of Trauma, Critical Care, General and Laparoscopic Surgery, Department of Surgery, Albany Medical Center, Albany, New York.

Reprints: Wendy E. Weller, Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York, University at Albany, One University Place, Room 167, Rensselaer, NY 12144-3456. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.