Outcomes of laparoscopic bariatric surgery in the elderly population

Abstract

There have been limited data on the safety of laparoscopic bariatric surgery in the elderly. To compare outcomes of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) between elderly (‡65 years) and nonelderly (18-64 years) patients. Using the 2011 to 2015 NSQIP database, we analyzed severely obese patients who underwent LRYGB or LSG. Univariate and multivariate analyses were performed to assess primary outcomes including 30-day mortality, serious morbidity, length of stay, and readmission. There were 41,475 LRYGB cases performed, including 2,010 (4.8%) cases in elderly patients. Compared with the nonelderly, elderly patients who underwent LRYGB had higher serious morbidity [odds ratio (OR) 5 1.43, confidence interval (CI) 5 1.16-1.76, P 5 0.001], but similar 30-day mortality (OR 5 0.8, CI 5 0.28-2.34, P 5 0.688). There were 44,550 LSG cases performed, including 2,055 (4.6%) cases in elderly patients. Compared with the nonelderly, elderly patients who underwent LSG had significantly higher serious morbidity (OR 5 1.44, CI 5 1.12-1.84, P 5 0.005) and higher 30-day mortality (OR 5 3.62, CI 5 1.34-9.83, P 5 0.011). Laparoscopic bariatric surgery is safe in the elderly population, and is similar between bariatric procedures. However, elderly patients have higher serious morbidity; therefore, they should be counseled regarding their higher risk, but should not be denied bariatric surgery based solely on their age.