Risks of weight loss surgery rise with age

Last Updated: 2006-03-28 16:24:27 -0400 (Reuters Health)

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - The risk of complications after weight loss or "bariatric" surgery increases slightly for each additional year over age 60, according to a report in the Archives of Surgery. The results also confirm previous reports that a "duodenal switch" operation is more likely to result in complications than the more commonly performed stomach bypass operation.

The stomach bypass results in weight loss by surgically "bypassing" the stomach, while the duodenal switch involves removing most of the stomach and reconfiguring the digestive tract to limit the amount of fat and calories that can be absorbed by the intestines.

"As with many other operations, age appears to be a risk factor for complications after bariatric surgery," lead author Dr. Robert W. O'Rourke, from Oregon Health & Science University in Portland, told Reuters Health. "But all of medicine is a balancing act between risks and benefits and I don't think our findings should be construed to mean that older age" rules out the possibility of weight loss surgery.

The new findings are based on an analysis of data from 452 patients who underwent bariatric surgery at the authors' institution between 2000 and 2003.

The rate of major complications was 10 percent with leakage from the connected intestines being the most common type. The minor complication rate was 13 percent.

For each additional year over age 60, the risk of postoperative complications rose slightly. Patients who underwent duodenal switch were twice as likely to experience complications than those treated with stomach bypass.

By contrast, body weight for height, gender, diabetes, surgeon experience, and whether the operation was done with a large incision or with a "laparoscopic" approach had no bearing on the risk of complications.

The overall death rate was 0.9 percent and, due to the small numbers of patients, the researchers were unable to identify risk factors for death.

"Obese individuals can reap a lot of benefits from bariatric surgery, but as our findings indicate, we need to talk with prospective patients about the risk associated with older age," O'Rourke said.

He added that his center, along with five others, is now involved in a forward-looking study to identify other factors that influence death and complications after bariatric surgery.

SOURCE: Archives of Surgery, March 2006.