• Michał R Janik, Rami R Mustafa, Tomasz G Rogula, Adel Alhaj Saleh, Mujjahid Abbas, and Leena Khaitan.
• University Hospital Cleveland Medical Center / Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warszawa, Poland. Electronic address: janiken@gmail.com.
• Surg Obes Relat Dis. 2018 Sep 1; 14 (9): 1276-1282.

BackgroundAn increase in the prevalence of obesity and longer life expectancy has resulted in an increased number of candidates over the age of 60 who are pursuing a bariatric procedure.ObjectiveThe aim of this study was to assess the safety of laparoscopic Roux-Y gastric bypass (LRYGB) compared to laparoscopic sleeve gastrectomy (LSG) in patients aged 60 years or older.SettingUniversity Hospital, United States METHODS: Preoperative characteristics and 30-day outcomes from the MBSAQIP 2015 were selected for all patients aged 60 years or older who underwent a LSG or LRYGB. LRYGB cases were closely matched (1:1) with LSG patients by age (±1 year), BMI (±1 kg/m2), gender, preoperative steroid or immunosuppressant use, preoperative functional health status and comorbidities including: diabetes, gastroesophageal reflux disease, hypertension, hyperlipidemia, venous stasis, sleep apnea and history of severe chronic obstructive pulmonary disease.ResultsA 3371 matched pairs were included in the study. The mean operative time in LRYGB was significantly longer in comparison to LSG patients (122 vs 84 min., P<0.001). Patients after LRYGB had a significantly increased anastomotic leakage rate (1.01% vs 0.47 %, p = 0.011), 30-day readmission rate (6.08% vs 3.74%, p < 0.001) and 30-day reoperation rate (2.49% vs 0.89%, p < 0.001) The length of hospital stay was longer in LRYGB. Mortality and bleed rate was comparable.ConclusionsLRYGB and LSG in patients aged 60 years or older are relatively safe in the short term with an acceptable complication rate and low mortality. However, LRYGB is more challenging and is associated with significantly increased rates of leakage events, 30-day reoperation, 30-day readmission, longer operative time and longer hospital stay.Copyright © 2018 American Society for Bariatric Surgery. All rights reserved.

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