A prospective study on the effect of reoperations on abdominal pain after bariatric surgery: the OPERATE study

Background: Abdominal pain after bariatric surgery (BS) is not uncommon. A number of patients require reoperation. Limited studies have investigated the outcome of reoperations for abdominal pain after BS. Objectives: To assess abdominal pain and quality of life after reoperation in patients with abdominal pain after BS. Setting: Bariatric center in the Netherlands. Methods: The study involved patients with a reoperation for abdominal pain after BS. Patients completed questionnaires on abdominal complaints and quality of life after inclusion, 3 months, and 6 months after reoperation. Clinical data were collected from records. Patients were compared on the basis of preoperative provisional diagnoses and postoperative diagnoses. Results: A total of 179 patients were included, with laparoscopic Roux-en-Y gastric bypass (86.0%), at a median of 27 months [9.5–76.0] after BS. Six months after reoperation, 51.6% continued to experience pain. However, a decline in pain severity was observed (visual analog scale baseline 83.50 [75.0–95.0] and 6 months 0 [.0–44.0] (P < .001). Patients without postoperative diagnosis had more pain after 6 months (P = .048). Gastrointestinal Quality of Life Index improved over time for all patients (94–110) (P < .001); however, no significant improvement was observed in patients without a preoperative provisional diagnosis. The general indication of health decreased for all patients (P < .001). Conclusions: Abdominal pain intensity decreased during follow-up upon reoperation after BS; however, in approximately one half of the patients, the pain remained and a decline in general health indication was observed regardless of postoperative diagnosis. These findings underscore the need for comprehensive management strategies to address post-BS pain and well-being.