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Is There an Upper Age Limit for Bariatric Surgery? Laparoscopic Gastric Bypass Outcomes in Septuagenarians

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Abstract

Purpose

Upper age limits for bariatric surgery are questioned on the merits of increased complication rates in the elderly and questionable efficacy. This study evaluates outcomes of bariatric surgery in patients ≥ 70 years of age.

Materials and Methods

Retrospective review was performed of patients ≥ 70 years of age who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) between 2001 and 2018. Primary endpoints were 30-day readmission, Clavien-Dindo grade III–V (CD III–IV) complications, and mortality. Secondary data included were weight loss, long-term outcomes, comorbidity resolution, hemoglobin A1C, and lipid panels.

Results

A total of 23 patients with an average age of 72 years (range 70–80 years) and mean BMI of 43.3 (range 37.3–56.0) were reviewed. Average length-of-stay was 2.4 days (range 1–6 days), with the only acute complication being aspiration pneumonia in one patient. Median follow-up was 69.3 weeks (range 9–875 weeks). One-year follow-up rate was 96%, during which no deaths or CD III-IV complications occurred. Subsequently, one patient experienced failure-to-thrive requiring temporary enteral nutrition. Average 1 year percent total weight loss (%TWL) was 29%, and this was maintained on subsequent follow-ups. Average 1 year percent excess weight loss (%EWL) was 60%, maintained long-term at 61%. Significant serum biochemical improvements included hemoglobin A1C (6.9 ± 1.4% to 5.6 ± 1.3%, p = 0.001), triglycerides (155 ± 49 mg/dL to 102 ± 41 mg/dL, p = 0.0003), and high-density lipoprotein cholesterol (48 ± 14 mg/dL to 58 ± 22 mg/dL, p = 0.004).

Conclusion

Laparoscopic RYGB is a safe and effective treatment for obesity and obesity-related comorbidities in septuagenarians.

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Authors and Affiliations

  1. Department of Surgery, Division of General Surgery, Mayo Clinic, 5777 E. Mayo Blvd., Phoenix, AZ, 85054, USA

    Jacob B. Hammond, Christopher J. Webb, Venkata S. K. K. Pulivarthi, David G. Pearson, Kristi L. Harold & James A. Madura II

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  1. Jacob B. Hammond
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Correspondence to James A. Madura II.

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For this type of study, formal consent is not required. Informed consent was obtained from all individual participants included in the study.

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This study was conducted after institutional IRB approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Hammond, J.B., Webb, C.J., Pulivarthi, V.S.K.K. et al. Is There an Upper Age Limit for Bariatric Surgery? Laparoscopic Gastric Bypass Outcomes in Septuagenarians. OBES SURG 30, 2482–2486 (2020). https://doi.org/10.1007/s11695-020-04532-1

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  • DOI: https://doi.org/10.1007/s11695-020-04532-1

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