Background

Bariatric surgery is an underutilized treatment option for severe obesity in the USA. An estimated 228,000 bariatric procedures were performed in 2017, representing a progressive increase since 2011. However, little large-scale data exists in the literature to determine whether bariatric surgery is becoming safer over time.

Methods

We used the MBSAQIP Participant Use File to compare early postoperative data from 2015 to 2017 of adults who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Descriptive statistics, independent t-tests, and chi-squared tests were used to describe the sample. Multivariable logistic regression was used to assess 30-day outcomes.

Results

Within the three-year time period, 467,444 cases met inclusion criteria. The volume of laparoscopic RYGB and SG procedures increased 21% from 2015 to 2017, which was predominantly due to increases in SG (28,999 increase over the three-year period vs. RYGB 2,152 volume increase; p < 0.001). Over the three years, the rates of complications requiring readmission, reoperation, and intervention decreased significantly (p < 0.01). Despite a yearly trend toward decreasing odds ratios, the reduction in mortality rate did not reach statistical significance (p =0.09).

Conclusions

In accordance with increased adoption of laparoscopic bariatric procedures from 2015 to 2017, there has been a significant decrease in the rates of complications necessitating readmission, reoperation, or intervention following RYGB and SG; the low mortality rate has remained stable with a trend towards improvement as well.