Early post-operative complications after metabolic and bariatric surgery in Misurata, Libya: Retrospective cross-sectional study

Abstract

Background: Bariatric procedures are generally safe and effective, but can be associated with complications. Early complications may include bleeding, leakage, venous thromboembolic events (VTE), wound infection, abdominal wall hematoma, and dehydration requiring admission. Aim: This study aimed to assess the incidence, clinical presentation, risk factors, and management of early postoperative complications within 30 days.

Methods: In this cross-sectional retrospective study, data were collected for all patients who underwent one of the following bariatric surgical operations: sleeve gastrectomy, one-anastomosis gastric bypass, Roux-en-Y gastric bypass, or single anastomosis sleeve ileal (SASI) from some Misurata hospitals between January and December 2024.

Results: The total number of patients was 992; of them, 648 (65.3%) were females and 344 (34.7%) were males. The patient’s body mass index (BMI) was 46.2 kg/m². The most common procedure done was sleeve gastrectomy, 606 (61%), followed by bypass surgery, 341 (34.3%), and 45 (4.6%) were revisional procedures. The most common early complication was abdominal wall hematoma, which occurred in 31 (3.1%) patients, followed by dehydration in 24 (2.4%) and postoperative bleeding, which occurred in 19 (1.9%) patients; of them, 14 (1.4%) patients experienced extra-luminal bleeding and 5 (0.5%) patients intraluminal bleeding, wound infection in 11 (1.3%) patients, VTE, as well as leakage, occurred in 6 (0.6%) patients, and prolonged ileus in 2 (0.25%) patients. Two cases died, with a mortality rate of 0.25%. Noticeably, the leakage was strongly related to higher BMI (p < 0.01), while bleeding was significantly associated with hypertensive patients (p < 0.05).

Conclusion: The incidence of early complications after bariatric surgery remains within the acceptable range in comparison with the other published studies. Most of the early complications could be managed conservatively, while surgical treatment might be required for some patients, especially with hemodynamic instability.

Disclaimer: This article was originally published by WisdomGale Publishing, 14 Rue de Grand-Bigard, 1082 Brussels, Belgium, and was migrated to International Medical Publishing Group(IMPG), India after the change of Publisher.