2021 General Surgery Presentations

MSS01: ENDOSCOPY AT THE TIME OF REVISIONAL BARIATRIC SURGERY
Sasha Hornock, DO1; Julia Bader, PhD1; Benjamin Clapp, MD2; 1William Beaumont Army Medical Center; 2Texas Tech Health Services Center

Introduction: Endoscopy is performed routinely during bariatric surgery.  It is often used for provocative testing during Roux-en-Y gastric bypass (RNYGB) and sleeve gastrectomy (SG).  Recent publications would indicate about one-quarter of bariatric cases are performed with concurrent endoscopy with a slight increase in time and no increase in complications. Does performing endoscopy decrease complication rates after revisional bariatric surgery (RBS)?

Methods: An analysis of the American College of Surgeons National Surgical Quality Initiative Program (NSQIP) was conducted for the years 2005-2017.  Seventeen postoperative outcomes were analyzed.  A 1:1 propensity score matching analysis was completed for 13 patient comorbidities and demographics. A McNemar’s test for paired categorical variables and a paired t-test for continuous variables were completed. The results were reported as the frequency and percentage for categorical variables and the mean (+/- standard deviation) for continuous variables. P was significant at 0.05.  

Results: A total of 7,249 revisional bariatric surgery (RBS) cases were identified. After propensity score matching for patient comorbidities and demographics 2,329 cases remained. Esophagogastroduodenoscopy (EGD) was performed in 375 (16%) of these patients.  There were  no differences in complication rates between the two groups. 

Conclusions: Endoscopy is performed in about one-sixth of patients undergoing RBS.  There is a slight increase in operative time but no difference in 30 day postoperative complications.