Long-term incidence of bariatric related procedures following laparoscopic gastric bypass: 15 to 20 years single institution experience.

Background: Long-term data on the likelihood of undergoing additional related operations after Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) remain scarce.

Objectives: The aims of this study are to identify the long-term incidence of bariatric related operations, patient's predictive factors, and most common operations in the 15-20 years following LRYGB.

Setting: Single Academic Institution, Center of Bariatric Excellence.

Methods: We performed a retrospective analysis of all LRYGB performed at Single Institution from 2003 to 2008. All subsequent bariatric related operations performed were manually reviewed, excluding upper endoscopies. Kaplan-Meier analysis was utilized to estimate the time to procedure. Cox regression was used to determine patient's factors associated with time until procedure.

Results: Of the 665 patients included, the median follow-up was 14 years. There were 248 (37.3%) patients with a related operation. After excluding panniculectomy, 199 (29.9%) had a related operation. The 3 most common operations were panniculectomy [n = 77 (12%)], followed by cholecystectomy [n = 64 (10%)], and internal hernia repair [n = 56 (8%)]. The Kaplan-Meier estimated incidence of related operation at 15 years was 43.7% and 35.3% after excluding panniculectomy. Females (HR = 1.77, 95% CI = [1.20, 2.62, p = 0.0039), age < 50 (HR = 1.42, 95% CI = [1.07, 1.88], p = 0.014), and BMI > 60 (HR = 2.77, 95% CI = [1.30, 5.91], p = 0.0083) were more likely to have a related operation.

Conclusion: Bariatric related operations are common after LRYGB. Nearly half of patients will eventually undergo a secondary operation as they approach 20 years post-LRYGB.