Late outcome of isolated gastric bypass

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).