Sleeve Gastrectomy vs. Roux-En-Y Gastric Bypass in Patients 65 Years of Age and Older: A Comparison of Short-term Outcomes

ABSTRACT Setting Academic Hospital, United States Objectives Bariatric surgery in the elderly population has been reported as feasible and safe. Sleeve gastrectomy (SG) seems to have fewer complications than Roux-En-Y gastric bypass (RYGB) even in the ≥65 years of age population. We analyzed the difference in weight loss between SG and RYGB in patients ≥65 years of age. Methods After internal review board approval, we retrospectively reviewed 2,486 patients who underwent either SG or RYGB between 2005 and 2018 at our institution. Basic demographics, preoperative body mass index (BMI) and comorbidities were described. We identified all patients ≥65 years of age and subsequently divided them into two groups based on type of bariatric procedure performed. Analysis and comparison of outcomes between these groups were completed. Post-operative BMI was reviewed at 6, 12 and 24 months and percent excess BMI loss (%EBMIL, as defined by the ASMBS clinical committee) was calculated accordingly. T-test and Chi2 analysis were performed for nominal and categorical variables, respectively. Results From 2,486 patients reviewed, 22.7% (n=565) were ≥65 years of age. From these, 43.1% (n=244) underwent SG and 56.8% (n=321) underwent RYGB. Caucasians and females were predominant in both groups. Mean age was similar for both populations (SG: 71.1±4.0, RYGB: 71.7±4.5; p=0.12). Pre-procedure mean BMI for both groups was close in value but the difference was statistically significant (40.5±5.5 for SG vs. 43.7±7.2 for RYGB; p Conclusions Both SG and RYGB are effective weight loss procedures for patients ≥65 of age. RYGB seems to have higher %EBMIL at 1 and 2 years; however, when compared to SG, complication rates appear to be almost three times higher.