Comparison of Hospital Readmission Rates after Laparoscopic Adjustable Gastric Band and Roux-En-Y Surgery

Friday, 17 July 2009: 8:30 AM

Erlinda C. Wheeler, DNS, RN1
Thomas Hardie, EdD, RN, CS, NP1
Gail Wynn, MD, FACS2
Isaias Irgau, MD, FACS2
1School of Nursing, University of Delaware, Newark, DE
2Christiana Institute of Advance Surgery, St. Francis Hospital, University of Delaware, Newark, DE

Learning Objective 1: Compare the rate of readmission between patients who have undergone Laparoscopic Roux-en Y gastric bypass and those who had Laparoscopic adjustable gastric band.

Learning Objective 2: State two nursing implications of these findings.

WHO reports that there is an escalating global epidemic of persons who are obese. Morbid obesity is a prelude to other diseases that affect essentially every organ system such as hypertension, atherosclerosis, heart attacks, sleep apnea, osteoarthritis, and diabetes.  In the, over 400,000 deaths per year can be attributed to obesity.  Bariatric surgery is currently the most effective and enduring treatment.  In recent years, laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric band (LAGB) are the most common bariatric technique performed worldwide.  Current research in this field focuses on the effectiveness and complication rates of these two competing surgical alternatives.  Patients will clearly benefit from better information in order to make informed decisions regarding safety and efficacy.

Purpose: The purpose of this study was to compare the rate of readmission and difference in time of readmission between patients who had undergone LRYGB and those who had the LAGB.

Methods: Data was collected from two hospitals surgery departments in,.

One thousand seventy patients have undergone bariatric surgery from 2002 to 2007.  Fifty one percent received LAGB and 49% received LRYGB procedure.

test was performed to determine if there was a difference in the rate of those requiring hospitalization between the two types of surgery.  A Kaplan-Meier survival analysis was also performed.

Results: The LAGB readmission rate was significantly less than Roux-en-Y bypass surgery.  The study also suggests that there is no statistical difference in the onset of readmission between the two groups. However, LAGB patients were readmitted to the hospital sooner. The magnitude of difference in mean days for readmission in the LRYGB patients indicates problems develop later.

Conclusion: The study shows clear advantage of LAGB than LRYGB on rates of readmission. Literature suggest other advantages of LAGB.