Trends In Bariatric Surgery Research Articles

A Population-Based Study of Bariatric Surgery Trends in Australia: Variations Reflect Continuing Inequities in Access to Surgery.

Obesity is increasingly prevalent and associated with higher morbidity and mortality. Bariatric surgery, particularly sleeve gastrectomy, provides durable weight loss and improves obesity-related conditions like type 2 diabetes and cardiovascular disease. Despite its benefits, significant concerns regarding inequities in access to bariatric surgery persist. This study aims to evaluate recent trends in bariatric surgery rates and to investigate patterns of access to bariatric surgery. A population-based study of age-adjusted bariatric procedure rates in adults in NSW, Australia, was conducted over the financial years 2013/14 to 2021/22. Trends in age-adjusted procedure rates were assessed by demographics and healthcare settings. In 2021/22, 179.6 bariatric procedures per 100,000 population were performed, an 89.7% increase since 2013/14 (p < 0.001). Laparoscopic sleeve gastrectomy, the most common procedure, increased by 94.1% to 112.6/100,000/year (p < 0.001). Females had 3.6 times higher rates than males (232.3/100,000/year vs 64.9/100,000/year). The greatest increases occurred in younger patients (125.9% in the 18-24 age group; 142.4% in the 25-34 age group, p < 0.001). Private hospital rates were 15.6 times higher than public (132.2/100,000/year vs 8.5/100,000/year) and rose 92.3% (p < 0.001), whilst public hospital rates declined by 17.9% (p = NS). Patients from regional areas had the highest rates (175.7/100,000/year) and largest increase (169.8%; 89.4/100,000/year to 241.8/100,000/year, p < 0.001). Bariatric surgery rates continue to increase, particularly among females, despite similar obesity prevalence between sexes. Most surgery is conducted in the private sector, suggesting differential access based on financial circumstances. Rates are highest in younger people, although obesity-related comorbidities increase with age. Regional patients undergo surgery at higher rates than rural patients despite greater obesity prevalence with increasing rurality. Efforts to address these disparities are essential to improve equitable access to obesity treatments.

Online Search Trends Related to Bariatric Surgery and Their Relationship with Utilization in Australia

PurposeThere is an abundance of online information related to bariatric surgery. Patients may prefer a specific type of bariatric surgery based on what they read online. The primary aim of this study was to determine online search trends in bariatric surgery over time in Australia and worldwide. The secondary aim was to establish a relationship between public online search activity and the types of bariatric surgery performed in Australia.Materials and MethodThe terms “adjustable gastric band,” “sleeve gastrectomy,” and “gastric bypass surgery” were submitted for search volume analysis in Australia and worldwide using the Google Trends “Topic” search function. This was compared alongside the numbers of gastric bandings, sleeve gastrectomies, and gastric bypass surgeries performed in Australia over time to determine if there was a relationship between the two.ResultsSearch trends for “adjustable gastric band” and “sleeve gastrectomy” in Australia were similar to trends seen worldwide. However, search trends for “gastric bypass surgery” differ between Australia and the rest of the world. It took at least a year for online searches to reflect the higher number of sleeve gastrectomies performed relative to gastric bandings. There was a lag time of over four years before online searches reflected the higher number of gastric bypass surgery performed compared to gastric banding.ConclusionSearch interests in Australia and worldwide were similar for gastric banding and sleeve gastrectomy but different for gastric bypass surgery. Online search activity did not have a significant association with the types of bariatric surgery being performed in Australia.Graphical

Early postoperative outcomes following bariatric surgery in the United States: Are racial disparities improving?

BackgroundBariatric surgery offers effective treatment for morbid obesity and associated medical comorbidities, with excellent short- and long-term outcomes. Although it has been well documented that racial minority bariatric patients have worse outcomes than White patients, it remains unclear whether this recognition has led to improvement. Herein, we assess recent trends in bariatric surgery among Black and White patients and compare early postoperative outcomes by race.MethodsPrimary sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients from 2015 to 2021 reported to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program were studied. Bariatric patients were stratified by race (Black and White) and perioperative outcomes were compared between matched Black and White patients. Primary outcome was 30-day mortality. Secondary outcomes included hospital readmissions, hospital length of stay (LOS), reoperation, and postoperative complications.ResultsOverall, there were 193,071 Black and 645,224 White primary bariatric patients, with a higher volume of SG and RGYB performed among White patients. A total of 219,566 Black and White bariatric patients were matched and included in the case–control. Black patients were found to have higher rates of 30-day mortality (0.02% vs. 0.01%; p = 0.03) and readmissions (3.68% vs. 2.65%; p < 0.001). There were no significant differences in LOS, reoperations, or overall postoperative complications. However, there was a higher postoperative pulmonary thromboembolism rate (0.16% vs 0.08%; p < 0.001).). The differences in perioperative outcomes stratified by race persisted over the study period (Fig. 1).ConclusionBlack bariatric surgery patients continue to have worse perioperative outcomes compared with their White counterparts. Further work must be done to determine contributing factors in order to effect improvement in outcomes in bariatric surgical care for racial minority patients.

Current trends in bariatric surgery in patients older than 65 years in Poland.

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; It is already known that bariatric surgery can improve the health and quality of life of morbidly obese patients of all ages. Our population is getting older. That is why the number of bariatric surgeries among obese people over 65 years of age is systematically increasing.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aims:&lt;/b&gt; The study aims to analyze the management of patients over 65 years of age in Polish bariatric centers.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Material and methods:&lt;/b&gt; The study was conducted on representatives from the 30 largest bariatric departments in Poland. By collecting surveys, we aimed to analyze changes in qualifications for surgery and care for elderly patients.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; 13 of 30 (43.3%) representatives responded to the survey. The remaining centers did not qualify patients over 65 years old for the surgical treatment of obesity. The mean percentage of patients over 65 who underwent bariatric surgery was 2.75. Most representatives (69.2%) chose SG as the procedure of choice in patients over 65 years of age. According to 84.6% of surgeons, age did not matter when qualifying patients over 65 years of age for BS. The majority of surgeons (53.8%) believed that bariatric surgery in older patients was comparable to the one in younger patients. Nine (69.2%) surgeons believed that there should be no age limit for bariatric surgery.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; Only almost half of the bariatric centers in Poland perform operations on patients over 65 years of age. Most Polish surgeons claim that operations on older and on younger patients have comparable benefits, and that there is no need for age limit.&lt;/br&gt.

Bariatric surgery trends and progress in Taiwan: 2010–2021

IntroductionTaiwan is a leading country regarding bariatric surgery in Asia-Pacific. Since 2010, the Taiwan Society for Metabolic and Bariatric Surgery (TSMBS) has been accountable for the national evolution of bariatric surgery and inaugurated a national database accordingly. This study aimed to analyze the bariatric surgery trends and progress in Taiwan from 2010 to 2021. Materials and methodsThe TSMBS database was collected on the basis of structured inquiries filled out by bariatric surgeons in Taiwan. All patients involving bariatric surgery were included. The data were stratified with the following objectives, including the types of bariatric procedures, demographic characteristics, and perioperative variables. A nationwide database was comprehensively analyzed and evaluated to determine the trends in the applications of the procedure. ResultsData of 30,026 patients were enrolled. A 2.5-fold increase was observed in bariatric procedures, from 1218 in 2010 to 3005 in 2021. Within 12 years, female accounts for 61.8 %. The revisional rate was 3.40 % during the exploration stage (2010–2013), 2.77 % during the maturity stage (2013–2018), and 5.10 % during the expansion stage (2019–2021). The top five of primary bariatric surgery is sleeve gastrectomy (SG, 63.05 %), gastric clipping surgery (GC, 11.17 %), Roux-en-Y gastric bypass (RYGB, 9.34 %), one anastomosis gastric bypass (OAGB, 8.80 %), and sleeve plus surgery (SG plus, 4.43 %). ConclusionThe trends and progress of Taiwan’s bariatric surgery within recent decades are presented in this article. Taiwan's bariatric surgery case number has increased steadily from 2010 to 2021. Amongst all, SG has become the most dominant procedure since 2011 while OAGB takes up second place in 2020.

Guideline compliance in bariatric surgery: a French nationwide study.

Strict adherence to guidelines with a comprehensive preoperative assessment and rigorous follow-up are essential to improve postoperative and long-term outcomes of bariatric surgery (BS). To investigate the trends in BS in France and to assess the compliance to guidelines in people with obesity before and after BS. University Hospital of Bordeaux, France. Data on patients who were admitted for a primary BS procedure in France between January 1 and April 1, 2014, were extracted from the French national health insurance system database. Data on patients' characteristics, preoperative assessment, hospitalization, and postoperative follow-up, including medical consultations, laboratory tests, and drug consumption, during the year preceding and the 2 years after BS were collected. Most of the 11,824 patients (60.4%) had sleeve gastrectomy. Rates of reimbursement for preoperative consultations with general practitioners, digestive surgeons, and endocrinologists or internists were 94.5%, 89.2%, and 63%, respectively. Laboratory tests for nutritional and obesity-related co-morbidity evaluations were performed in 94.3% and 91.4%, respectively. Rates of consultation with general practitioners, digestive surgeons, and endocrinologists or internists dropped from 93.1%, 91.2%, and 29.2%, respectively, the first year to 88.4%, 50.3%, and 20%, respectively, the second year after BS (P < .001). Reimbursements for vitamin, iron, and calcium supplementation dropped from 66.6%, 24.9%, and 21%, respectively, the first year to 52.1%, 19.3%, and 11.7%, respectively, the second year after BS (P < .001). Overall compliance with guidelines is improving. While preoperative medical assessment is nearly optimal, efforts still should be made in order to improve long-term follow-up in general and patient adherence to micronutrient supplementation in particular.

Trends in risk factors for readmission after bariatric surgery 2015-2018.

Readmission after bariatric surgery is multifactorial. Understanding the trends in risk factors for readmission provides opportunity to optimize patients prior to surgery identify disparities in care, and improve outcomes. This study compares trends in bariatric surgery as they relate to risk factors for all-cause readmission. Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) participating facilities. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was used to analyze 760,076 bariatric cases from 854 centers. Demographics and 30-day unadjusted outcomes were compared between laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (LSG), and Roux-en-Y gastric bypass (RYGB) performed between 2015 and 2018. A multiple logistic regression model determined predictors of readmission. A total of 574,453 bariatric cases met criteria, and all-cause readmission rates decreased from 4.2% in 2015 to 3.5% in 2018 (P < .0001). The percentage of non-Hispanic Black adults who underwent bariatric surgery increased from 16.7% of the total cohort in 2015 to 18.7% in 2018 (P < .0001). The percentage of Hispanic adults increased from 12.1% in 2015 to 13.8% in 2018 (P < .0001). The most common procedure performed was the LSG (71.5%), followed by RYGB (26.9%) and 1.6% LAGB (1.6%) (P < .0001). Men were protected from readmission compared with women (odds ratio [OR]: .87; 95% confidence interval [CI]: .84-.90). Non-Hispanic Black (OR: 1.52; 95% CI: 1.47-1.58)] and Hispanic adults (OR: 1.14; 95% CI: 1.09-1.19) were more likely to be readmitted compared with non-Hispanic White adults. LSG (OR: 1.27; 95% CI: 1.10-1.48) and RYGB (OR: 2.24; 95% CI: 1.93-2.60) were predictive of readmission compared with LAGB. Readmission rates decreased over 4 years. Women, along with non-Hispanic Black and Hispanic adults, were more likely to be readmitted. Future research should focus on gender and racial disparities that impact readmission.

National Trends and Outcomes in Adolescents Undergoing Bariatric Surgery.

In the US, obesity continues to be a severe health issue now affecting adolescents. Bariatric surgery remains the most effective treatment for obesity, but use among adolescents remains low. The objective of this study was to identify current national trends in bariatric surgery among adolescents. Using the Nationwide Inpatient Sample database, adolescents aged 9 to 19 with a diagnosis of morbid obesity who underwent a laparoscopic gastric bypass (Roux-en-Y gastric bypass) or laparoscopic sleeve gastrectomy (SG) between 2015 and 2018 were identified. Demographics, comorbidities, and in-hospital complications were collected. National estimates were calculated. The trend of annual number of operations was determined by Kruskal-Wallis rank test. Between 2015 and 2018, 1,203 adolescents were identified, resulting in a nationwide estimate of 4,807 bariatric cases. The number of bariatric operations increased annually from 1,360 in 2015 to 1,740 operations in 2018 (p = 0.0771). The majority of patients were female (76%), 17 to 19 years old (84.1%), and White (47.9%). Most patients underwent SG (82.0%). Black and Hispanic patients comprised 40.2% of the cohort. Significant comorbidities included diabetes, dyslipidemia, nonalcoholic fatty liver disease, hypertension, and sleep apnea. The average length of stay decreased from 2.12 days to 1.64 days. There were no in-hospital mortalities, and complications were less than 1%. With the increasing prevalence of obesity among adolescents in the US, bariatric surgery increased over time but was performed less in patients younger than 16 years of age and racial minorities. Bariatric surgery among adolescents remains safe, with extremely low complication rates and zero in-hospital mortality.

US national trends in bariatric surgery: A decade of study

BackgroundSince the 1990s, the number of bariatric surgeries has dramatically increased, including the number of bariatric centers in the United States; no recent studies have yet assessed trends of bariatric surgery. This study aims to assess the trends of bariatric surgery and the change in utilization by the type of surgery, from 2006 to 2015, using real-world data. MethodsA cross-sectional analysis of MarketScan databases of privately insured beneficiaries aged equal to or more than 18 years, to assess the annual incidence rate of bariatric surgery type of surgery from 2006 to 2015. Linear regression analysis was used to assess the significance of bariatric surgery changes over time. ResultsA gradual increase in overall bariatric surgery was observed from 43.5 per 100,000 in 2006 to 70.6 per 100,000 in 2009. This increasing trend plateaued from 2010 to 2015. Among all bariatric surgeries performed, the sleeve gastrectomy showed a significant increase from (n = 596) 11% in 2006 to (n = 15,425) 70% in 2015 (P < .001), whereas there was a decrease in Roux-en-Y from (n = 10,129) 45% in 2010 to (n = 5074) 24% in 2015 (P < .001). ConclusionUtilization of bariatric surgery showed a gradual increase in the first 5 years, with steady rates in the last 5 years of the study period. Sleeve gastrectomy and Roux-en-Y remain the most performed bariatric procedures. Laparoscopic surgery continues to dominate bariatric surgery compared with open surgery.

Opportunities of the «Bareoreg» Russian National Bariatric Registry in assessing trends in bariatric surgery

Opportunities of the «Bareoreg» Russian National Bariatric Registry in assessing trends in bariatric surgery

Perinatal Outcomes Following Bariatric Surgery Between a First and Second Pregnancy: A Population Data Linkage Study

(BJOG. 2020;127:345–354) Obesity in women of reproductive age and pregnant women is a risk factor for maternal and neonatal morbidities, including fetal growth restriction, gestational diabetes, and childhood obesity. Bariatric surgery is a successful long-term solution to treat obesity and its comorbidities, and, as rates of both obesity and bariatric surgery rise, is an increasingly important consideration in reproductive health care. While other studies have assessed pregnancy outcomes after bariatric surgery, this study examined differences in perinatal outcomes for women who had bariatric surgery between their first and second pregnancies and those who did not. Further, the study assessed trends in bariatric surgery as well as characteristics of women having bariatric surgery.

Trends in bariatric surgery and incidentalomas at a single institution in Saudi Arabia: a retrospective study and literature review

ABSTRACTBACKGROUND: Data are lacking on trends in bariatric surgery and the frequency of incidental findings in Saudi Arabia.OBJECTIVE: Report on trends in bariatric surgery as well as our experience in incidental findings along with a literature review (mainly on gastrointestinal stromal tumor).DESIGN: Retrospective chart and literature review.SETTINGS: Academic tertiary care center.PATIENTS AND METHODS: We conducted a retrospective study at King Khalid University Hospital and analyzed the data collected from 2009 to 2019. We collected data on age, body mass index (BMI), H pylori infection, type of bariatric surgery performed, and type and location of incidental findings.MAIN OUTCOME MEASURES: Incidental findings during or after bariatric surgery (in pathology specimen).SAMPLE SIZE: 3052 bariatric surgeries, 46 patients with incidentalomas.RESULTS: The mean and standard deviation for the age of the 46 patients with incidentalomas was 42.1 (13.9) years and the mean (SD) preoperative BMI was 43.4 (6.4) kg/m2. Of 3052 bariatric surgeries performed, the most common type was sleeve gastrectomy (93.9%), followed by gastric bypass surgery (4.58%) and gastric banding (1.47%). The total frequency of incidentalomas was 1.5%; 10.8% of patients had gastrointestinal stromal tumors (GIST), with the stomach being the commonest site for incidental findings. Eighty percent of the patients with GIST were positive for H pylori (P=.01 vs negative patients).CONCLUSION: The number of incidentalomas and other findings were consistent with other reports. All these findings suggest that bariatric surgeons should take special care before, during, and after a laparoscopic operation in obese patients.LIMITATIONS: Since this is a single-center, retrospective study, we did not collect data on important variables such as gender, socioeconomic status of the patient, and family history of obesity, and we did not perform a preoperative esophagogastroduodenoscopy.CONFLICT OF INTEREST: None.

Trends in bariatric surgery in Texas: an analysis of a statewide administrative database 2013-2017.

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) tracks 30-day outcomes of bariatric patients, but only at accredited centers. Presently, these cases are not broken down by state. Administrative databases can be used to answer some of the questions that are not asked by clinical databases and also to validate those databases. We proposed using the inpatient and outpatient administrative databases in Texas to examine both the numbers and trends of bariatric surgery in Texas over a 5-year period. The Texas Inpatient Public Use Data File (IPUDF) and the Texas Outpatient Public Data File (OPUDF) were examined for the years 2013-2017. We searched for patients undergoing laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), laparoscopic Roux-en-Y gastric bypass (LRYGB) and duodenal switch. Robotic assisted cases were also examined. There were 105,199 bariatric cases performed in Texas from 2013 to 2017. There were 173 centers performing bariatric surgery. The most common operation performed was the sleeve gastrectomy at 73,663 case (70% of total). Gastric bypasses were second at 22,890 cases. During this time period, LAGB almost disappeared; dropping from 2090 cases in 2013 to 115 cases in 2017, with removal of 2097 LAGB in the study period in the OPUDF. During this time period, there was a lower growth rate of the number of SG in the IPUDF with a large increase in SG performed with outpatient status, while LRYGB remained relatively stable. Rates of bariatric surgery in Texas are increasing slowly. The dominant procedure is the SG with a trend towards being done under outpatient status. LAGB has been essentially phased out. There is an increase in SG being performed under 'outpatient' status.

Private and Public Bariatric Surgery Trends in New Zealand 2004-2017: Demographics, Cardiovascular Comorbidity and Procedure Selection.

For bariatric surgery, patient selection, procedural choice and availability has changed over time internationally. We analysed the annual volume and location of bariatric surgery in New Zealand by demographic characteristics, clinical history and procedure. Patients who underwent bariatric procedures between 1 January 2004 and 31 December 2017 were identified through New Zealand hospitalisation records. Hospitalisation and medication data were used to indicate a clinical history of cardiovascular disease (CVD) and/or diabetes. Publicly funded intervention rate by ethnicity was calculated using year- and sex-specific ethnic population estimates and obesity prevalence statistics. This study included 9109 patients, undergoing gastric bypass (GB, n = 3323) and sleeve gastrectomy (SG, n = 5452) as the most common procedures. Nationally, annual bariatric surgery volume increased in the public sector, from 34 to 516 between 2004 and 2017, with a similar increase in available private sector figures. Public recipients were significantly more likely to have a history of diabetes (33.8% vs 14.4%) and/or CVD (9.0% vs 4.7%) than private recipients. Male recipients had higher prevalence of diabetes (29.9% vs 17.6%) and CVD (12.9% vs 4.1%) than female recipients. After adjustment for the adult population prevalence of morbid obesity, Pacific people had half the intervention rate of European and Māori. Bariatric surgery is increasing in frequency in New Zealand, with SG and GB being the most common procedures. Significant differences in patient characteristics exist between the public and private sectors. Ensuring equitable selection of publicly funded bariatric surgery candidates remains a challenge.

Trends in Bariatric Surgery: a 5-Year Analysis of the Israel National Bariatric Surgery Registry.

The worldwide prevalence of obesity nearly tripled between 1975 and 2016. There are limited data quantifying national trends. The aim of this study is to evaluate and summarize current trends in bariatric surgery in Israel. Data for all bariatric surgeries (BS)performed between January 2014 and December 2018 was collected from the Israel National Bariatric Surgery Registry(INBSR) and analyzed. During the study period, 42,296 BS were included in the INBSR. Females accounted for 68% and the mean age and body mass index were 41.6 ± 12.6years and 42.0 ± 5.4kg/m2, respectively. Most of the patients were Jewish, but there was a significant rise in number of Arabs undergoing BS during the study period. There was a gradual decline in the annual numbers of BS, except for a small rise in 2015. There was a significant rise in the rate of One Anastomosis-Mini Gastric Bypass (OAGB-MGB), from 0.1% in 2014 to 46.1% in 2018, making it the most prevalent BS in that year. Laparoscopic sleeve gastrectomy (SG) surgeries decreased steadily, from 80% in 2014 to 37% in 2018. The annual rate of Roux-en-Y gastric bypass (RYGB) remained essentially constant at 10%. The annual rates of gastric banding decreased sharply and the annual rates of duodenal switch, single anastomosis duodenal switch and biliopancreatic diversion were negligible. Bariatric surgery was distributed evenly between private (50.4%) and public (49.6%) hospitals. The numbers of BS are decreasing in Israel. There is a gradual but noticeable shift from SG to OAGB-MGB.

Bariatric Surgery Trends in the U.S.: 1% is the Loneliest Number.

Bariatric Surgery Trends in the U.S.: 1% is the Loneliest Number.

A343 Trends in bariatric surgery in Texas: an analysis of a statewide administrative database 2013-2017.

A343 Trends in bariatric surgery in Texas: an analysis of a statewide administrative database 2013-2017.

2081-P: Obesity and Bariatric Surgery Trends in Type 1 Diabetes

The prevalence of obesity and its complications and comorbidities continue to increase. It is well established that obesity is a major etiologic factor in the onset of type 2 diabetes (T2DM) and that bariatric surgery (BS) is an effective management strategy for both weight and glycemic control in obese T2DM patients. The relationship between obesity and type 1 diabetes (T1DM) is less clear though recent reports suggest a recent surge in the prevalence of obesity among T1DM patients. To explore the prevalence of obesity in T1DM and the impact of bariatric surgery in these patients a 1 year (2018) retrospective chart review of T1DM patients was done and the identified patients were compared to T2DM patients seen over the same time period in the Ochsner clinical network. Of 93,367 subjects with T2DM seen over the 1 year period, 62, 034 (66.4%) are obese and of these 18,670 (30%) are morbidly obese. The T1DM patients over the same period are 7,143 of which 3,728 (52%) are obese and 969 (26%) are morbidly obese. Over this period while 1,818 Obese T2DM patients (2.9% of the cohort) had BS only 6 obese T1DM patients (0.16%) of the cohort had BS. This group consists of mostly Caucasian (5/6) women (5/6) with 3 having gastric bypass and 4 having sleeve gastrectomy. While the prevalence of cardiometabolic comorbidities (hypertension, dyslipidemia, ESRD, CAD, and CVD) were essentially similar in both cohorts of obese diabetics, the effects of bariatric surgery on weight, HBA1c, blood pressure and lipids were more variable in the T1DM patient than the T2DM patients. Obesity is presently nearly as prevalent in T1DM as T2DM. Morbid obesity is just as prevalent in both diabetes cohorts. While BS remains underutilized as a management strategy in obese T2DM it remains a rarity in obese T1DM and the little data available suggests that its impact on cardiometabolic surrogates may be more variable in this unique cohort. More study is needed of the potential utility and impact of BS in weight management of obese T1DM. Disclosure G.I. Uwaifo: None.

Present trends in bariatric surgery in Poland.

IntroductionAs obesity has become a major health problem in Poland and bariatric procedures are the best way of treatment, an increasing trend has been observed in Polish bariatric surgery for the last decade.AimOur purpose was to provide an updated overview of the bariatric surgical procedures performed in Polish institutions in comparison to the situation in Europe as well as to analyze the trends in Polish bariatric surgery over the last decades.Material and methodsA questionnaire about the number and type of bariatric procedures performed in 2016 was sent to all Polish surgical departments. Two hundred and sixty surgical departments returned the questionnaires.ResultsTwenty-seven departments reported having performed bariatric operative or endoscopic procedures in 2016. The total number of procedures reported was 1958, the most popular being the laparoscopic sleeve gastrectomy (LSG). More than 99% of procedures were performed using laparoscopic techniques. The most common operations were: LSG (64.6%, n = 1032) and laparoscopic Roux-en-Y gastric bypass (LRYGB) (18.2%; n = 291), followed by one anastomosis gastric bypass (OAGB) (8.3%; n = 132) and laparoscopic adjustable gastric banding (LAGB) (7.3%; n = 117).ConclusionsRegisters of bariatric procedures provide information that helps in planning treatment and predicting possible complications. Adequate reporting of bariatric procedures is necessary to present the importance of the high incidence of obesity and the importance of its treatment. To collect reliable data, a national Polish bariatric surgery registry should be created.

Deep vein thrombosis prophylaxis: Are we overdoing? An Asian survey on trends in bariatric surgery with a systematic review of literature.

Background:Obesity is a risk factor for deep vein thrombosis (DVT) and venous thromboembolism (VTE). VTE is the most common cause of mortality in patients undergoing bariatric surgery. There is considerable variation in practice regarding methods, dosages and duration of prophylaxis in this patient population. Most of the literature is based on Western patients and specific guidelines for Asians do not exist.Methods:We conducted a web-based survey amongst 11 surgeons from high-volume centres in Asia regarding their DVT prophylaxis measures in patients undergoing bariatric surgery. We collected and analysed the data.Results:The reported incidence of DVT and VTE ranged from 0% to 0.2%. Most surgeons (63.64%) preferred to use both mechanical and chemoprophylaxis with low-molecular-weight heparin being the most preferred form of chemoprophylaxis (81.82%). There was an equal distribution of weight-based, body mass index-based and fixed-dose regimens. Duration of chemoprophylaxis ranged from 3–5 days after surgery to 2 weeks after surgery. For high-risk patients, 60% surgeons preferred to start chemoprophylaxis at least 1 week before surgery. Routine use of inferior vena cava filters in high-risk patients was not preferred with some surgeons adopting a selective use (36.36%).Conclusion:The purpose of this survey was to understand the trends in DVT prophylaxis amongst different high-volume bariatric centres in Asia and to relate the same with the existing literature on the different steps in prophylaxis. There is, however, a need for consensus guidelines for DVT prophylaxis in Asian obese.