Bariatric surgery and fatality rates

It’s higher than you think. Something to consider when looking at the procedure:

About 1% of bariatric surgery patients die within a year of surgery, researchers here found, and the case fatality rate approaches 6% after five years.
But a retrospective look at all of the bariatric surgery performed in Pennsylvania from 1995 through 2004 found a “substantial excess” of deaths by suicide and coronary heart disease.

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Anonymous
Indirect post-surgery deaths aside, these kind of articles just make me want to repeat the same set of facts over and over again:
1) Unless you have exceptional circumstances, never have an open bariatric procedure. Even then, consult a top-level surgeon to make sure that it’s not just out of the expertise of the one you’ve chosen. The healing differences are that dramatic.
2) Have your laparascopic procedure done by someone who has completed at least 100 of that type and is preferably FACS. If your insurance will cover it, go as far as you have to to get an experienced, reputable provider, not just Dr. X in that hospital down the street who started doing them last year out of a chop shop. It is definitely worth making the trip to a high-volume academic center.
3) If you are high risk (BMI 50+) or have a ridiculous amount of comorbidities, consider two-staging your procedure for your health. For this, make sure your surgeon does a two-stage routinely, not just did a sleeve course last weekend. High risk means more chance of complications, and it’ll pay to shop around.
4) Ask if your surgeon ever refers difficult post-surgery complications to another hospital/surgeon (you’d be surprised how many do). Try to get that surgeon instead. Consider paying fees out of pocket to get that surgeon, especially if you have a BMI 60+ or a serious cardiac condition.
5) Have realistic expectations of what the surgery can do for you. It’s a tool that shoves off the first 50-100+ pounds. It’s not a miracle cure that will prevent regain if you continue to eat 3x the normal caloric intake. And it requires life-long yearly follow-up (lapband excepted) to monitor vitamin/mineral levels. And you’re going to want plastic surgery if your weight stabilizes, with little chance of your insurance covering it.
Since I’ve seen plenty of studies quantifying the decrease in death rates caused by the drastic weight loss of surgery, and many more showing that death rates (granted, 1-5 years post-surgery) are under 0.01% when an experienced surgeon is used and the patient follows up over time, I’d take this study as a reminder that yes, major procedures occasionally go wrong rather than a significant contribution to the field.

Bariatric surgery and fatality rates

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