RESECTIONAL GASTRIC BYPASS IS A NEW ALTERNATIVE IN MORBID-OBESITY

BACKGROUND: Severe obesity is a common serious health problem in the U nited States. Medical therapy is often ineffective. A variety of surgi cal procedures have been employed for treatment of morbid obesity. Sur gical therapy continues to evolve. METHODS: Eighty-five patients have undergone subtotal gastrectomy and retrocolic Roux-en-Y gastrojejunost omy for weight control at our institution. We refer to this procedure as resectional gastric bypass (RGB), Thirty-eight patients have underg one RGB as conversion from failed or problematic prior bariatric proce dures. Forty-seven patients have had RGB as their primary bariatric pr ocedure. RESULTS: Twenty-six patients undergoing RGB for conversion of an anatomically or functionally failed prior bariatric procedure have had mean additional weight loss of 37% excess body weight (EBWL) in 1 8 months follow-up. Twelve patients undergoing RGB for intractable sid e effects of prior bariatric procedures have all had clinical improvem ent. Forty-seven patients undergoing RGB as a primary procedure have h ad EBWL of 53%, in mean follow-up of 11 months. For the entire series, major complications were one anastomotic leak, one reexploration for suspected subphrenic abscess, and one major pulmonary embolus. These p atients recovered. There was no mortality in the series. CONCLUSIONS: Resectional gastric bypass is a new alternative for salvage of a faile d or problematic prior bariatric procedure. it is also effective as a primary weight control operation. (C) 1998 by Excerpta Medica, Inc.