ArticleObesity surgery2026
Impact of Center Accreditation Level on Laparoscopic Bariatric Surgery Outcomes: A Retrospective Cohort Study.
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAccreditation systems are designed to standardize surgical care and improve outcomes in bariatric surgery, yet evidence on the effects of accreditation transitions within a single center is scarce. This study evaluated whether achieving Center of Excellence (COE) status influenced postoperative safety and perioperative process measures in a high-volume bariatric unit.
methodsA retrospective cohort study was conducted using prospectively collected data from the German national registry (StuDoQ|MBE). All consecutive patients undergoing laparoscopic bariatric surgery at a single high-volume German bariatric Center between January 2018 and November 2025 were included. Patients were grouped by accreditation era (non-COE vs. COE). The primary outcome was any intraoperative or 30-day postoperative complication graded as Clavien–Dindo grade ≥ II. Multivariable logistic regression was used to estimate adjusted odds ratios (aOR).
resultsA total of 2,760 patients were analyzed (2,114 non-COE; 646 COE). Baseline characteristics were largely comparable except for ASA distribution. Overall complication rates were low and identical between eras (1.9% vs. 1.9%, p > 0.9). COE status was not associated with decreased complication risk after adjustment (aOR 1.07, 95% CI 0.52–2.02, p = 0.71). Operative time (median 39 vs. 40 min, p < 0.001) and extended LOS (5.5% vs. 0.8%, p < 0.001) significantly decreased during COE accreditation. Adhesiolysis was more frequently performed in the COE than in the non-COE (5.7% vs. 3.4%, p < 0.001).
conclusionTransition to COE accreditation did not change 30-day complication rates and coincided with a reduction in LOS and operative time, suggesting improved perioperative efficiency without compromising safety despite increased procedural complexity.
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