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| ORIGINAL ARTICLE
|Year : 2021 | Volume
| Issue : 2 | Page : 213-220
Complications after bariatric surgery: A multicentric study of 11,568 patients from Indian bariatric surgery outcomes reporting group
Ramen Goel1, Amrit Manik Nasta1, Madhu Goel1, Arun Prasad2, Gurvinder Jammu3, Mathias Fobi4, Mohamed Ismail5, Praveen Raj6, Raj Palaniappan7, Sandeep Aggarwal8, Vivek Bindal9, Abhishek Katakwar10, Amar Vennapusa11, Aparna Govil Bhasker12, Atul Peters13, Deep Goel14, Digvijay Bedi15, Jaydeep Palep16, Lakshmi Kona17, Magan Mehrotra18, Manish Baijal19, Mohit Bhandari4, Nandakishore Dukkipati20, Randeep Wadhawan21, Sarfaraz Baig22, Satish Pattanshetti23, Surendra Ugale24
1 Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
2 Department of Surgery, Manipal Hospital, New Delhi, India
3 Director and Chief Surgeon, Bariatric Surgery, Jammu Hospital, Jalandhar, Punjab, India
4 Director of Clinical Affairs and Research, Mohak Bariatrics and Robotics; Clinical Professor of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
5 Bariatric Surgeon, Moulana Hospital, Perintalmanna; Bariatric Surgeon, RIMS Hospital, Kottayam, Kerala, India
6 Bariatric Surgeon, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India
7 Lead Consultant, Bariatric, Metabolic and Robotic Surgery, Institute of Bariatrics, Apollo Hospitals, Chennai, Tamil Nadu, India
8 Bariatric Surgeon, AIIMS, New Delhi, India
9 Vice-Chairman, Institute of Minimal Access, Metabolic and Bariatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
10 Associate Director, Laparoscopic/Robotic Bariatric and Metabolic Surgery, AIG Hospitals, Hyderabad, Telangana, India
11 Chief Consultant Metabolic and Bariatric Surgeon, Dr. Amar Bariatric and Metabolic Center, Hyderabad, Telangana, India
12 Bariatric and Laparoscopic GI Surgeon, Gleneagles Global Hospital, Parel, Mumbai; Bariatric and Laparoscopic GI Surgeon, Apollo Hospital, Navi Mumbai, Maharashtra, India
13 HOD and Senior Consultant, Apollo Institute of Bariatric and Metabolic Surgery, Indraprastha Apollo Hospitals, New Delhi, India
14 Department of Surgical Gastroenterology, Bariatric and Metabolic Surgery, BLK Super Specialty Hospital, New Delhi, India
15 Hope Obesity Center, Bhopal, Madhya Pradesh, India
16 Department of Bariatric and Minimal Access Surgery, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India
17 Senior Consultant, Gleneagles Global Hospital, Hyderabad, Telangana, India
18 Director, Bariatric Surgery, Apex Hospital, Moradabad, Uttar Pradesh, India
19 Director, Institute of Minimal Access, Metabolic and Bariatric Surgery, Max Hospital, New Delhi, India
20 Bariatric Surgeon, Livlife Hospitals, Hyderabad, Telangana, India
21 Department of Minimal Access, Bariatric and Gastrointestinal Surgery, Fortis Hospital, New Delhi, India
22 Department of Minimal Access Surgery, Belle Vue Clinic, Kolkata, West Bengal, India
23 Ruby Hall Clinic, MJM Hospital, Pune, Maharashtra, India
24 Director, Bariatric and Metabolic Surgery, Kirloskar and Virinchi Hospitals, Hyderabad, Telangana, India
Background: Complications after bariatric surgery are not uncommon occurrences that influence the choice of operations both by patients and by surgeons. Complications may be classified as intra-operative, early (<30 days post-operatively) or late (beyond 30 days). The prevalence of complications is influenced by the sample size, surgeon's experience and length and percentage of follow-up. There are no multicentric reports of post-bariatric complications from India.
Objectives: To examine the various complications after different bariatric operations that currently performed in India.
Materials and Methods: A scientific committee designed a questionnaire to examine the post-bariatric surgery complications during a fixed time period in India. Data requested included demographic data, co-morbidities, type of procedure, complications, investigations and management of complications. This questionnaire was sent to all centres where bariatric surgery is performed in India. Data collected were reviewed, were analysed and are presented.
Results: Twenty-four centres responded with a report on 11,568 bariatric procedures. These included 4776 (41.3%) sleeve gastrectomy (SG), 3187 (27.5%) one anastomosis gastric bypass (OAGB), 2993 (25.9%) Roux-en-Y gastric bypass (RYGB) and 612 (5.3%) other procedures. Total reported complications were 363 (3.13%). Post-operative bleeding (0.75%) and nutritional deficiency (0.75%) were the two most common complications. Leaks (P = 0.009) and gastro-oesophageal reflux disease (P = 0.019) were significantly higher in SG, marginal ulcers in OAGB (P = 0.000), intestinal obstruction in RYGB (P = 0.001) and nutritional complications in other procedures (P = 0.000). Overall, the percentage of complications was higher in 'other' procedures (6.05%, P = 0.000). There were 18 (0.16%) reported mortalities.
Conclusions: The post-bariatric composite complication rate from the 24 participating centres in this study from India is at par with the published data. Aggressive post-bariatric follow-up is required to improve nutritional outcomes.
Dr. Amrit Manik Nasta
Centre for Metabolic Surgery, Wockhardt Hospitals, 1877, Doctor Anandrao Nair Marg, Near Agripada Police Station, Mumbai Central, Mumbai - 400 011, Maharashtra
Source of Support: None, Conflict of Interest: None
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