A prospective study on the effect of reoperations on abdominal pain after bariatric surgery: the OPERATE study

Abstract

BackgroundAbdominal pain after bariatric surgery (BS) is not uncommon. A number of patients require reoperation. Limited studies have investigated the outcome of reoperations for abdominal pain after BS. ObjectivesTo assess abdominal pain and quality of life after reoperation in patients with abdominal pain after BS. SettingBariatric center in the Netherlands. MethodsThe study involved patients with a reoperation for abdominal pain after BS. Patients completed questionnaires on abdominal complaints and quality of life after inclusion, 3 months, and 6 months after reoperation. Clinical data were collected from records. Patients were compared on the basis of preoperative provisional diagnoses and postoperative diagnoses. ResultsA total of 179 patients were included, with laparoscopic Roux-en-Y gastric bypass (86.0%), at a median of 27 months [9.5–76.0] after BS. Six months after reoperation, 51.6% continued to experience pain. However, a decline in pain severity was observed (visual analog scale baseline 83.50 [75.0–95.0] and 6 months 0 [.0–44.0] (P < .001). Patients without postoperative diagnosis had more pain after 6 months (P = .048). Gastrointestinal Quality of Life Index improved over time for all patients (94–110) (P < .001); however, no significant improvement was observed in patients without a preoperative provisional diagnosis. The general indication of health decreased for all patients (P < .001). ConclusionsAbdominal pain intensity decreased during follow-up upon reoperation after BS; however, in approximately one half of the patients, the pain remained and a decline in general health indication was observed regardless of postoperative diagnosis. These findings underscore the need for comprehensive management strategies to address post-BS pain and well-being.