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PATIENT SAFETY

The Risk of Pulmonary Aspiration in Patients After Weight Loss Due to Bariatric Surgery

Jerome Jean, MD^*, Vincent Compère, MD^*, Veronique Fourdrinier, MD^*, Caroline Marguerite, MD^*, Isabelle Auquit-Auckbur, MD, Pierre Yves Milliez, MD, and Bertrand Dureuil, MD^*

From the Departments of *Anesthetics and Intensive Care, Plastic Surgery, Rouen University Hospital, University of Rouen, France.

Address correspondence and reprint requests to V. Compère, Rouen University Hospital, Department of Anesthetics and Intensive care, University of Rouen, 1 rue de Germont, 76031 Rouen, France. Address e-mail to vincent.compere{at}chu-rouen.fr.

Abstract

BACKGROUND: We conducted a study including patients with gastric banding or gastroplasty who previously underwent plastic or functional surgery to assess the risk of pulmonary aspiration.

METHODS: A retrospective case–control study was performed including all patients undergoing a plastic or functional surgery over a 5-yr period (2000–2005) at Rouen University Hospital. Two groups were defined: the postbariatric group included patients who previously had bariatric surgery (laparoscopic adjustable gastric banding or Mason’s vertical gastroplasty) before undergoing the plastic surgery; all other patients were assigned to the control group. Data included all anesthetic management and were recorded in the hospital computer database. The incidence of pulmonary aspiration was the outcome variable.

RESULTS: One hundred ninety-eight plastic and functional operations (66 cases and 132 controls) were performed. Pulmonary aspiration was significantly (P < 0.006) higher in the postbariatric group (4 patients: 6%) than in the nonbariatric group (0 patient). For this complication, all patients had previously undergone gastric banding. One patient who did not receive prokinetic prophylaxis required intensive care for severe pulmonary alteration.

CONCLUSION: The risk of perioperative pulmonary aspiration in a patient after weight loss due to gastric banding was considered significant.