Objective
To complete a long-term (>5 years) follow-up of patients undergoing isolate
d gastric bypass for severe obesity.
Summary Background Data
Previous experience as well as randomized trials suggested that the ideal o
peration for obesity should rely on manipulation of satiety rather than the
production of malabsorption. Such an operation should incorporate a small
gastric pouch of less than 30 mt placed in a dependent position on the less
er curvature of the stomach, not dependent on staples, and separated from t
he remaining stomach with a retrocolic, retrogastric Roux-en-Y gastrojejuno
stomy without external support.
Methods
The authors established an obesity clinic where patients were seen six time
s during the first year and semiannually thereafter. Emphasis was placed on
defining success in terms of approximation to normal body-mass index
Results
Of 274 patients, 243 (89%) were followed up for 5.5 +/- 1.5 years. Before s
urgery. the patients were obese (n = 13), morbidly obese (n = 134), or supe
r-obese (n = 96). The obese and morbidly obese group achieved an excellent
result, and the super-obese a good result. individual results showed consid
erable variation from the mean.
Conclusions
This study of isolated gastric bypass with a 5.5-year follow-up rate of 88.
6% revealed a success rate of 93% in obese or morbidly obese patients and 5
7% in super-obese patients, Isolated gastric bypass compares favorably with
biliopancreatic diversion in terms of weight loss, maximum weight loss, we
ight regain, current body-mass index, and percentage of patients with a bod
y-mass index less than 35 kg/m(2).