Role of intraoperative fluids on hospital length of stay in laparoscopic bariatric surgery: a retrospective study in 224 consecutive patients

Surg Endosc. 2015 Oct;29(10):2960-9. doi: 10.1007/s00464-014-4029-1. Epub 2014 Dec 17.


Background: Studies are unclear regarding optimal intraoperative fluid management during laparoscopic bariatric surgery. The purpose of this 1-year study was to investigate the role of intraoperative fluid administration on hospital length of stay (hLOS) and postoperative complications in laparoscopic bariatric surgery.

Methods: Patient data analyzed included previously reported demographics, comorbidities, and intraoperative fluid administration on the duration of hLOS and incidence of postoperative complications.

Results: Logistic regression analysis of demographic and comorbidity variables revealed that BMI (P = 0.0099) and history of anemia (P = 0.0084) were significantly associated with hLOS (C index statistic, 0.7). Lower rates of intraoperative fluid administration were significantly associated with longer hLOS (P = 0.0005). Recursive partitioning observed that patients who received <1,750 ml of intraoperative fluids resulted in longer hLOS when compared to patients who received ≥ 1,750 ml (LogWorth = 0.5). When intraoperative fluid administration rates were defined by current hydration guidelines for major abdominal surgery, restricted rates (<5 ml/kg/h) were associated with the highest incidence of extended hLOS (>1 postoperative day) at 54.1 % when compared to 22.9 % with standard rates (5-7 ml/kg/h) and were lowest at 14.5 % in patients receiving liberal rates (>7 ml/kg/h) (P < 0.0001). Finally, lower rates of intraoperative fluid administration were significantly associated with delayed wound healing (P = 0.03).

Conclusions: The amount of intravenous fluids administered during laparoscopic bariatric surgery plays a significant role on hLOS and on the incidence of delayed wound healing.

Keywords: Complications; Fluid management; Hospital length of stay; Laparoscopic bariatric surgery; Obesity; Predictor variables.

MeSH terms

  • Adult
  • Anemia / epidemiology
  • Bariatric Surgery*
  • Body Mass Index
  • Female
  • Fluid Therapy*
  • Humans
  • Intraoperative Care*
  • Laparoscopy*
  • Length of Stay / statistics & numerical data*
  • Louisiana / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Wound Healing