Background

With improved outcomes following laparoscopic weight loss surgery (Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy [SG]) there is increased focus on decreasing post-operative length of stay (LOS). Previous reports indicate higher 30-day mortality and serious complications following ambulatory (AMB) RYGB procedures. We sought to assess outcomes following AMB-RYGB or SG using the MBSAQIP® data registry.

Methods

Participant user files from MBSAQIP were reviewed for patients undergoing AMB-RYGB or SG (2015-17). Patients were grouped as AMB (LOS1d). Exclusion criteria were LOS >4d, Age 75yrs, revision surgery, gastric banding, BMI

Results

After exclusions, 408,895 patients remained (2.43% AMB). 111,270 patients underwent RYGB (1,032 AMB) and 297,616 SG (8,941 AMB). After multivariate logistic regression adjusted for comorbidities and matching, no patients were lost in the AMB arm and demographics/comorbidities were similar. Analysis of 30-day mortality, reoperation, or readmission demonstrated no increased risk in AMB-RYGB vs. non-AMB-RYGB (p=0.5986, p=0.4587, p=0.1571 respectively), and no differences in major/minor complications. Analysis of AMB-SG revealed no differences in 30-day mortality, reoperation, or readmission (p=0.0832, p=0.3117, p=0.8247 respectively) vs. non-AMB-SG. Non-AMB-RYGB and SG patients had fewer drains placed, and non-AMB-SG patients were less likely to have unplanned ICU admissions (p=0.0050).

Conclusions

This analysis using the MBSAQIP database demonstrates comparable safety between AMB vs. non-AMB-RYGB and SG with minimal or no increased risk of major or minor complications.