Mild elevation of fasting plasma glucose is a strong risk factor for postoperative complications in gastric bypass patients.

BACKGROUND

Bariatric surgery may be associated with surgical complications. The aim of the study was to identify significant risk factors for postoperative complications in patients undergoing Roux-en-Y gastric bypass (RYGBP).

METHODS

The study consisted of 75 consecutive patients undergoing RYGBP. Full medical examination was performed, and the following parameters were assessed in the fasting state: plasma glucose, insulin, leptin, serum lipids, liver function tests, and lipoprotein Lp(a). All subjects had oral 75 g glucose tolerance test before the surgery. All complications occurring within 6 months after the RYGBP were recorded. The patients were divided into Group 1 - patients in whom complications occurred, and Group 2 - patients with no complications in the 6-month period.

RESULTS

Postoperative complications occurred in 16 patients (wound infection, hernia, splenic injury, gastro-jejunal obstruction, duodenal ulcer, lower limb deep vein thrombosis). 3 significant risk factors for postoperative complications within 6 months after gastric bypass were found: 1) fasting plasma glucose >/= 6.0 mmol/l (OR 11.0; 95% confidence interval (CI) 2.1-77.3), 2) age >/=40 years (OR 5.89, 95% CI 1.35-29.4), and 3) BMI >/=45 kg/m(2) (OR 4.1, 95% CI 1.04-17.2).

CONCLUSION

RYGBP is associated with increased risk of developing early postoperative complications in subjects with even slightly elevated fasting plasma glucose, age >/=40 and BMI >/=45 kg/m(2).