Background

Bariatric surgery in geriatric patients (>65-years-old) has been proven safe and effective. Revisional bariatric surgery is infrequently required for cases of refractory obesity. Given rising life expectancy and the ever-growing obesity epidemic, revisional bariatric surgery will undoubtedly become more common in older patients. There is a paucity of data regarding revisional surgery the advanced age population. We hypothesize that revisional bariatric surgery is a viable and safe option in patients of advanced age. Methods: Retrospective chart review of bariatric revisions performed at two bariatric centers of excellence between 2011 and 2017. Perioperative and long-term outcomes were compared between patients >65-years-old and those <65.

Results

135 bariatric revisions were performed for weight loss purposes. Of these 10% (N=13) were >65 years old and 95% (N=122) were female. There were no differences between groups for preop BMI or co-morbidities. Types of revision (conversion to sleeve, conversion to bypass, limb lengthening and duodenal switch) were similar within and between groups. There were no differences between morbidity and mortality between the two groups, although the older cohort did require longer hospital length of stay (Table). Excess weight loss was similar between groups at 12-months (Figure), as was resolution of obesity related co-morbid conditions (Table).

Conclusions

Bariatric revisions in patients over 65-years-old appears to be safe and effective. Revisional surgery in this population was not shown to have increased morbidity or mortality with similar excess body weight loss and resolution of obesity associated comorbid conditions when compared to a younger cohort.