Utility of Inflammatory Markers in Detection of Perioperative Morbidity After Laparoscopic Sleeve Gastrectomy, Laparoscopic Roux-en-Y Gastric Bypass, and One-Anastomosis Gastric Bypass—Multicenter Study

Background The most commonly performed bariatric operations are laparoscopic sleeve gastrectomy (LSG) and bypass surgeries (laparoscopic one-anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB)), and predicting perioperative morbidity is crucial for early, safe patient...

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Veröffentlicht in:Obesity surgery 2020-08, Vol.30 (8), p.2971-2979
Hauptverfasser: Wysocki, Michał, Małczak, Piotr, Wierdak, Mateusz, Walędziak, Maciej, Hady, Hady Razak, Diemieszczyk, Inna, Proczko-Stepaniak, Monika, Szymański, Michał, Dowgiałło-Wnukiewicz, Natalia, Szeliga, Jacek, Pędziwiatr, Michał, Major, Piotr
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Sprache:eng
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Zusammenfassung:Background The most commonly performed bariatric operations are laparoscopic sleeve gastrectomy (LSG) and bypass surgeries (laparoscopic one-anastomosis gastric bypass (OAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB)), and predicting perioperative morbidity is crucial for early, safe patient discharge. We aimed to determine whether C-reactive protein (CRP) and white blood count (WBC) measured on the first postoperative day predicts perioperative morbidity in the first 30-days after LSG and bypass surgeries. Methods We retrospectively analyzed data for 1400 patients who underwent bariatric surgery in seven bariatric centers from 2014 to 2018. Patients were divided into a complicated group (patients with postoperative complications) and a non-complicated group. We also performed separate analyses for LSG and bypass surgeries. Results Patients were 929 women (66%) and 471 men (34%) with a median age of 42 years (range, 35–51 years); 1192 patients underwent LSG (85%), 120 underwent LRYGB (9%), and 80 underwent OAGB (6%). We performed ROC analyses to set cut-off points, followed by multivariate logistic regressions. CRP > 33.32 mg/L increased the odds ratio (OR) of perioperative complications after LSG 2.27 times, while WBC > 12.15 × 10 3 /μL on postoperative day 1 was associated with a 3.34-times greater or of developing complications. WBC > 13.78 × 10 3 /μL was associated with a 13.34-times higher or of perioperative morbidity in patients undergoing bypass surgeries. Conclusion Even slightly elevated CRP and WBC on postoperative day 1 should alert surgeons to the potential risk of perioperative morbidity.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-020-04636-8