Early Post-Operative Complications After Bariatric Surgery in Misurata, Libya: Retrospective Cross-Sectional Study

Background: Bariatric procedures are generally safe and effective but can be associated with complications. Early complications may include bleeding, leakage, venous thromboembolic events (VTE), wound infection, abdominal wall hematoma, and dehydration requiring admission. Aim: to assess the incidence, clinical presentation, risk factors, and management of early postoperative complications within 30 days. Methods: In this cross-section retrospective study, data was collected for all patients who underwent one of the following bariatric surgical operations: sleeve gastrectomy, one-anastomosis gastric bypass, Roux-en-Y gastric bypass (RNYGB), or single anastomosis sleeve ileal (SASI) from some Misurata hospitals between January to December 2024. Results: The total number of patients was 861; of them, 562 (65.3%) were females and 299 (34.7%) were males. The body mass index (BMI) for the patients was a mean of 46.2 kg/m². The most common procedure done was sleeve gastrectomy, 554 (64.3%), followed by bypass surgery, 292 (33.9%), and 15 (1.8%) were revisional procedures. The most common early complication was abdominal wall hematoma, which occurred in 27 (3.1%) patients, followed by dehydration in 21 (2.4%) and postoperative bleeding (POB), which occurred in 16 (1.9%) patients; of them, 12 (1.4%) patients experienced extra-luminal bleeding (ELB) and 4 (0.5%) patients Intraluminal bleeding (ILB), wound infection in 11 (1.3%) patients, VTE, as well as leakage, occurred in 5 (0.6%) patients, and prolonged ileus in 2 (0.25%) patients. Two cases died, with a mortality rate of 0.25%. Noticeably, the leakage was strongly related to higher BMI (P<0.01), while bleeding was significantly associated with hypertensive patients (P<0.05). Conclusion: The incidence of early complications after bariatric surgery remains within the acceptable range compared to the other published studies. Most of the early complications could be managed conservatively, while surgical treatment might be required for some patients, especially with hemodynamic instability.