Preventing Surgical Site Infections after Bariatric Surgery: Value of Perioperative Antibiotic Regimens

Teena Chopra; Jing J Zhao; George Alangaden; Michael H Wood; Keith S Kaye

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2010;10(3):317-328. 

In This Article

Types of Bariatric Surgical Procedures

Historically, the three most common types of bariatric surgical procedures include an open and laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB). The laparoscopic sleeve gastrectomy has become a popular procedure in the past 4–5 years but the number of procedures that have been performed for this type of surgery and the number of published reports have been small in comparison with the other bariatric surgical procedures.

A recent multicenter prospective study of 4776 bariatric procedures showed that the combined end point of 30-day mortality, major thrombotic complication, re-intervention and prolonged hospitalization was 1.0% for LAGB, 4.8% for laparoscopic RYGB and 7.8% for open RYGB, with an overall mortality rate of 0.3%.[11] The major risk factors for increased complication rates in this study were obstructive sleep apnea, poor functional status or a history of prior thrombotic events. The introduction of laparoscopic RYGB has been associated with a significant reduction in perioperative mortality and complications.[11,12] The complication rate associated with LAGB is even lower than that seen with laparoscopic RYGB (1 vs 3.3%).[12]

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