• Søren Neermark, Janne Schurmann Tolstrup, Povl Ulrik Becker, Morten Bay-Nielsen, Jens Fromholt-Larsen, Lau Caspar Thygesen, and Thue Bisgaard.
• GastroUnit, Surgical and Medical Division, Centre for Surgical Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
• Ann. Surg. 2020 May 1; 271 (5): 891-897.

ObjectiveTo study long-term gastrointestinal surgical hospital burden (hospital readmissions and gastrointestinal surgical procedures) after laparoscopic gastric bypass.BackgroundLittle is known about gastrointestinal surgical hospital burden after laparoscopic gastric bypass.MethodsDanish patients undergoing laparoscopic gastric bypass (BMI >35-50) from January 1, 2005 to December 31, 2013 were included (100% follow-up). The nonsurgical reference group were individuals with BMI of ≥ 30 drawn from The Danish National Health Surveys from 2005 to 2013. The primary outcome was gastrointestinal surgical hospital burden. Secondary outcome was mortality. Age, body mass index (BMI), gender, and calendar time (time of surgery and nonsurgical survey), diabetes status was adjusted for in a multivariate Poisson regression model.Results13,582 bariatric surgical patients and 45,948 reference individuals were included with a mean follow-up time of 4.7 years (SD 2.4). The incidence rate ratio (IRR) for hospital re-re-admission was 2.17 higher in the intervention group (95% CI 2.04-2.31). Sensitivity analysis showed that patients operated before 2010 had a higher incidence for re-re-admission than after. IRR for surgical gastrointestinal procedures was 6.56 (CI 6.15-6.99) and 3.04 (CI 3.51-4.17) after 1 and 5 years for the intervention group compared with the reference group. Surgery for internal hernia was the most common abdominal procedure. The mortality odds ratio was 0.84 (CI 0.65-0.96).ConclusionsGastrointestinal surgical hospital burden was significantly higher in the first 5 years after gastric bypass compared with a matched nonsurgical reference group of obese citizens.

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