Postbariatric Panniculectomy: Postoperative Complications by Weight Loss Surgery Type.

Background: More than 250,000 patients undergo bariatric surgery each year in the United States. Approximately 21% will undergo subsequent body contouring after massive weight loss. Patients with prior bariatric surgery are at a greater risk for complications relative to the general population. However, it is unknown whether bariatric surgery type is associated with differential complication risk after panniculectomy.

Methods: A retrospective chart review of postbariatric patients who underwent abdominal panniculectomy at a single large quaternary care center was performed. Postoperative complications were graded according to the Clavien-Dindo classification. Descriptive statistics, multivariable logistic regression, and power calculations were performed.

Results: In total, 216 patients were included. Restrictive bariatric surgery accounted for 48.6%, whereas 51.3% had a history of malabsorptive bariatric surgery. The overall rate of complications was 34.3% (restrictive, 36.2%; malabsorptive, 32.8%; P = 0.66). Wound complications were observed in 25.5% ( n = 55) of patients. Systemic complications occurred in 11.1% of patients overall, with statistically similar rates between restrictive and malabsorptive groups. After adjusting for both patient and operative factors, no significant difference in total complications (OR, 1.15; 95% CI, 0.47 to 2.85; P = 0.76), systemic complications (OR, 0.26; 95% CI, 0.05 to 1.28; P = 0.10), or wound complications (OR, 2.31; 95% CI, 0.83 to 6.41; P = 0.11) was observed.

Conclusions: Complication rates following panniculectomy in bariatric surgery patients are high and predominantly related to wound healing. No significant difference between type of bariatric surgery and complication risk was found.

Clinical question/level of evidence: Therapeutic, III.