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This study aims to evaluate recent trends in the utilization of bariatric procedures, associated complications, and conversions using an\u00a0administrative claims database in the United States.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We included adults\u00a0who had bariatric procedures from 2000 to 2020 with continuous enrollment for at least 6\u00a0months in the MarketScan Commercial Claims and Encounters database. Index bariatric procedures and subsequent revisions or conversions were identified using CPT codes. Baseline comorbidities and postoperative complications were identified with\u00a0ICD-9-CM and ICD-10 codes. Cumulative incidences of complications\u00a0were estimated at\u00a030-days, 6-months, and 1-year and compared with stabilized inverse probability of treatment weighted Kaplan\u2013Meier analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We identified 349,411 bariatric procedures and 5521 conversions or revisions. The sampled SG volume appeared to begin declining in 2018 while Roux-en-Y gastric bypass (RYGB) remained steady. Compared to RYGB, SG was associated with lower 1-year incidence [aHR, (95% CIs)] for 30-days readmission [0.65, (0.64\u20130.68)], dehydration [0.75, (0.73\u20130.78)], nausea or vomiting [0.70, (0.69\u20130.72)], dysphagia [0.55, (0.53\u20130.57)], and gastrointestinal hemorrhage [0.43, (0.40\u20130.46)]. Compared to RYGB, SG was associated with higher 1-year incidence [aHR, (95% CIs)] of esophagogastroduodenoscopy [1.13, (1.11\u20131.15)], heartburn [1.38, (1.28\u20131.49)], gastritis [4.28, (4.14\u20134.44)], portal vein thrombosis [3.93, (2.82\u20135.48)], and hernias of all types [1.36, (1.34\u20131.39)]. There were more conversions from SG to RYGB than re-sleeving procedures. SG had a significantly lower 1-year incidence of other non-revisional surgical interventions when compared to RYGB.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The overall volume of bariatric procedures within the claims database appeared to be declining over the last 10\u00a0years. The decreasing proportion of SG and the increasing proportion of RYGB suggest the specific complications of SG may be driving this trend. Clearly, RYGB should remain an important tool in the bariatric surgeon\u2019s armamentarium.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-024-10985-7","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T16:02:02Z","timestamp":1718899322000},"page":"4613-4623","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Bariatric surgery: trends in utilization, complications, conversions and revisions"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9850-3869","authenticated-orcid":false,"given":"Justin L.","family":"Hsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherin","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie M.","family":"Hodges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris B.","family":"Agala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"Farrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"10985_CR1","first-page":"1","volume":"360","author":"CM Hales","year":"2020","unstructured":"Hales CM, Carroll MD, Fryar CD, Ogden CL (2020) Prevalence of obesity and severe obesity among adults: United States, 2017\u20132018. 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Justin Hsu, Sherin Ismail, Maggie Hodges, Chris Agala, and Timothy Farrell have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"The study was deemed exempt by the University of North Carolina, as it contained deidentified secondary data, and therefore informed consent was not required (IRB # 20-0443).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}