• Erik Stenberg, Eva Szabo, Göran Agren, Erik Näslund, Lars Boman, Ami Bylund, Jan Hedenbro, Anna Laurenius, Göran Lundegårdh, Hans Lönroth, Peter Möller, Magnus Sundbom, Johan Ottosson, Ingmar Näslund, and Scandinavian Obesity Surgery Registry Study Group.
• *Department of Surgery, Lindesberg Hospital, Lindesberg, Sweden †Department of Surgery, Örebro University Hospital, Örebro, Sweden ‡Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden §Department of Surgery, Lycksele Hospital, Lycksele, Sweden ¶Department of Surgery, Ersta Hospital, Stockholm, Sweden ‖Skåne University Hospital, Lund University, Lund, Sweden **Department of Surgery, Aleris Obesity Skåne, Lund, Sweden ††Department of Surgery, Sahlgrenska University Hospital, Gastrosurgical Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ‡‡Österlenskirurgin, Simrishamn Hospital, Simrishamn, Sweden §§Department of Surgery, Kalmar County Hospital, Kalmar, Sweden; and ¶¶Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
• Ann. Surg.. 2014 Dec 1;260(6):1040-7.

ObjectiveTo identify risk factors for serious and specific early complications of laparoscopic gastric bypass surgery using a large national cohort of patients.BackgroundBariatric procedures are among the most common surgical procedures today. There is, however, still a need to identify preoperative and intraoperative risk factors for serious complications.MethodsFrom the Scandinavian Obesity Surgery Registry database, we identified 26,173 patients undergoing primary laparoscopic gastric bypass operation for morbid obesity between May 1, 2007, and September 30, 2012. Follow-up on day 30 was 95.7%. Preoperative data and data from the operation were analyzed against serious postoperative complications and specific complications.ResultsThe overall risk of serious postoperative complications was 3.4%. Age (adjusted P = 0.028), other additional operation [odds ratio (OR) = 1.50; confidence interval (CI): 1.04-2.18], intraoperative adverse event (OR = 2.63; 1.89-3.66), and conversion to open surgery (OR = 4.12; CI: 2.47-6.89) were all risk factors for serious postoperative complications. Annual hospital volume affected the rate of serious postoperative complications. If the hospital was in a learning curve at the time of the operation, the risk for serious postoperative complications was higher (OR = 1.45; CI: 1.22-1.71). The 90-day mortality rate was 0.04%.ConclusionsIntraoperative adverse events and conversion to open surgery are the strongest risk factors for serious complications after laparoscopic gastric bypass surgery. Annual operative volume and total institutional experience are important for the outcome. Patient related factors, in particular age, also increased the risk but to a lesser extent.

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