Comparing risk factors and reoperation rates for laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Obesity has become a growing concern globally as a leading risk factor for several chronic diseases such as diabetes, hypertension, cardiovascular disease and more. Many patients with obesity undergo metabolic and bariatric surgery (MBS) to lose weight and improve their comorbid conditions. Despite the generally accepted efficacy of these operations, some patients will not achieve substantial and sustained weight loss or will experience significant postoperative complications, leading to reoperation within 30 days after the first procedure. Using the 2022 American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, we selected patients who underwent either a laparoscopic sleeve gastrectomy (LSG) or a laparoscopic Roux-en-Y gastric bypass (LRYGB). Furthermore, we divided patients in each operation cohort into those who underwent reoperation within 30 days and those who did not. Patients who underwent a laparoscopic Roux-en-Y bypass experienced higher rates of reoperation (1.84%) compared to those undergoing an LSG (0.65%). In reoperation groups within both cohorts, comorbidities that commonly impact patients with obesity, such as diabetes, sleep apnoea and gastroesophageal reflux disease, were associated with higher rates of reoperation. As the prevalence of obesity increases worldwide, it is vital to understand the risk factors and complications associated with different types of MBS. Physicians choosing to utilise an LRYGB procedure over an LSG should do so while carefully considering the increased risk of reoperation.