ArticleSurgical endoscopy2026
Short-term safety and efficacy of revision or conversion metabolic and bariatric surgery in older adults: an analysis of the MBSAQIP database.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundA subset of older adults who undergo metabolic and bariatric surgery (MBS) eventually requires revision or conversion of their index MBS procedure. However, the relative safety of revision/conversion MBS in the older population as compared to younger adults is unclear.
methodsWe conducted a retrospective comparative analysis of postoperative outcomes of revision/conversion MBS in patients 18-65 years of age (Younger) versus > 65 years of age (Older) using the 2020-2024 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Our primary outcome was 30-day incidence of major complications, defined as Clavien-Dindo Grade ≥ 2.
resultsFrom a total of 118,208 revision/conversion MBS procedures, 8042 (6.8%) were in the Older age group. Older patients had a lower BMI, were more likely to be male, and had a greater incidence of comorbid medical conditions at baseline compared to younger patients. After adjusting for patient and procedure-level covariates, older patients had a significantly greater odds of major complications (adjusted OR 1.21 [95% CI 1.11-1.32], p < 0.0001), anastomotic or staple line leak (adjusted OR 1.68 [95% CI 1.31-2.13], p < 0.0001), and reoperation (adjusted OR 1.17 [95% CI 1.02-1.33], p = 0.026). Older patients also had a longer average operative time (Mean Difference (MD) 12.05 min [95% CI 10.48-13.62], p < 0.0001), length of hospital stay (MD 0.32 days [95% CI 0.27-0.37], p < 0.0001), and a lower change in BMI at 30 days (MD 0.1 kg/m
conclusionBased on MBSAQIP data, revision/conversion MBS is associated with a significantly greater risk of morbidity in older patients as compared to younger adults. These findings suggest that revision/conversion MBS should be offered in the > 65 age group with careful consideration of patient factors and closer perioperative monitoring to optimize postoperative outcomes.
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