Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
Contemporary trends in the incidence, risk factors, and management of postoperative leak after sleeve gastrectomy and gastric bypass from 2007-2023.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Howard Ryan, Finks Joseph B, Petersen Sarah, Carlin Arthur M, Obeid Nabeel, Ehlers Anne, Varban Oliver, Kia Michael, Finks Jonathan
Аннотация
BACKGROUND: Although postoperative leak is one of the most feared complications after bariatric surgery, trends in its incidence, risk factors, and contemporary management are unclear.
OBJECTIVES: Describe trends in the incidence of postoperative leak after bariatric surgery, identify factors associated with postoperative leak, and describe trends in leak management.
SETTING: Hospitals in Michigan.
METHODS: This retrospective cohort study used a statewide clinical registry to identify adults who underwent primary laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass in a mature quality improvement-driven US healthcare setting between January 1, 2007 and December 31, 2023. The main outcome was postoperative leak within 30 days of surgery. Multivariable logistic regression was used to identify factors associated with postoperative leak.
RESULTS: 108,708 patients with a mean age of 45.0 (11.7) years and 86,712 (79.8%) females underwent primary bariatric surgery, of whom 74,268 (68.3%) underwent sleeve gastrectomy and 34,440 (31.7%) underwent gastric bypass. 628 (.58%) leaks occurred. Over the 17-year study period, the incidence of postoperative leak decreased by .06 (95% confidence interval [CI]: .04-.08) percentage points (pp) per year, from 1.06% in 2007 to .45% in 2023. Individually, there was a significant decrease in the incidence of postoperative leak for both procedures (sleeve gastrectomy .06 [95% CI: .03-.10] pp per year; gastric bypass .03 [95% CI: .01-.06] pp per year). Factors associated with higher odds of postoperative leak included prior gastric surgery (adjusted odds ratio [aOR]: 5.92 [95% CI: 2.57-13.65]), gastric bypass (aOR: 2.46 [95% CI: 1.87-3.24]), active or recent smoking (aOR: 1.68 [95% CI: 1.14-2.47]), and diabetes (aOR: 1.35 [95% CI: 1.01-1.80]). Among patients who developed a postoperative leak, 311 (49.5%) were managed operatively, while 317 (50.5%) were managed nonoperatively.
CONCLUSIONS: Over the last 2 decades, there was a significant decrease in the incidence of postoperative leak after sleeve gastrectomy and gastric bypass.
OBJECTIVES: Describe trends in the incidence of postoperative leak after bariatric surgery, identify factors associated with postoperative leak, and describe trends in leak management.
SETTING: Hospitals in Michigan.
METHODS: This retrospective cohort study used a statewide clinical registry to identify adults who underwent primary laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass in a mature quality improvement-driven US healthcare setting between January 1, 2007 and December 31, 2023. The main outcome was postoperative leak within 30 days of surgery. Multivariable logistic regression was used to identify factors associated with postoperative leak.
RESULTS: 108,708 patients with a mean age of 45.0 (11.7) years and 86,712 (79.8%) females underwent primary bariatric surgery, of whom 74,268 (68.3%) underwent sleeve gastrectomy and 34,440 (31.7%) underwent gastric bypass. 628 (.58%) leaks occurred. Over the 17-year study period, the incidence of postoperative leak decreased by .06 (95% confidence interval [CI]: .04-.08) percentage points (pp) per year, from 1.06% in 2007 to .45% in 2023. Individually, there was a significant decrease in the incidence of postoperative leak for both procedures (sleeve gastrectomy .06 [95% CI: .03-.10] pp per year; gastric bypass .03 [95% CI: .01-.06] pp per year). Factors associated with higher odds of postoperative leak included prior gastric surgery (adjusted odds ratio [aOR]: 5.92 [95% CI: 2.57-13.65]), gastric bypass (aOR: 2.46 [95% CI: 1.87-3.24]), active or recent smoking (aOR: 1.68 [95% CI: 1.14-2.47]), and diabetes (aOR: 1.35 [95% CI: 1.01-1.80]). Among patients who developed a postoperative leak, 311 (49.5%) were managed operatively, while 317 (50.5%) were managed nonoperatively.
CONCLUSIONS: Over the last 2 decades, there was a significant decrease in the incidence of postoperative leak after sleeve gastrectomy and gastric bypass.