Rhabdomyolysis after Laparoscopic Bariatric Surgery

Background: Postoperative rhabdomyolysis is an uncommon event. The aim of this study was to determine the incidence of rhabdomyolysis following laparoscopic obesity surgery. Methods: Rhabdomyolysis was studied prospectively. Over a 6-month period, 66 consecutive patients underwent bariatric surgery (gastric banding (n=50) and gastric bypass (n=16)). All patients underwent laparoscopic procedures. A range of blood tests, including serum creatine phosphokinase (CPK) level and serum creatinine, were systematically performed before surgery, and on the first and third day postoperatively. Rhabdomyolysis was defined as a postoperative CPK level >1,050 IU/L. Results: Serum CPK was noted to increase significantly postoperatively to >1,050 units in 3 patients (6%) in the adjustable banding group and 12 patients (75%) in the gastric bypass group (P <0.01). In the bypass group, 4 patients (25%) had a serum CPK level >10,000 IU/L, but there were none in the gastric banding group. All patients with CPK level >10,000 IU/L had BMI >60 kg/m2. No patients experienced acute renal failure. Conclusion: Rhabdomyolysis occurred in 22.7 % of 66 consecutive patients undergoing laparoscopic bariatric surgery. Risk factors were identified: massive obesity and long duration of the operation. Early diagnosis may have significant impact on outcome by preventing or reducing the severity of complications from rhabdomyolysis. CPK level should be performed systematically after obesity surgery.