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Complications and Suboptimal Weight Loss After Roux-en-Y Bypass
What Causes Complications and Unsatisfactory Weight Loss After Laparoscopic Bypass
Predictors of Complication and Suboptimal Weight Loss After Laparoscopic Roux-en-Y Gastric Bypass
An analysis of patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) may identify factors predictive of complication and of suboptimal weight loss.
Subjects comprised 188 consecutive patients with severe obesity who met National Institutes of Health consensus guidelines for bariatric surgery. The bariatric operation was Laparoscopic Roux-en-Y Gastric Bypass. The study measured complications requiring therapeutic intervention and percentage of excess body weight lost at 1 year after surgery.
Of the 188 patients who underwent laparoscopic RYGB, 50 (26.6%) developed complications that required an invasive therapeutic intervention, including 2 deaths. The average follow-up was 351 days (range, 89-1019 days). Multivariate analysis by stepwise logistic regression identified surgeon experience, sleep apnea (P = .003; odds ratio, 3.0; 95% confidence interval, 1.3-7.1), and hypertension (P = .07; odds ratio, 2.0; 95% confidence interval, 1.0-4.0) as predictors of complications. The most common complication requiring therapeutic intervention was stricture at the gastrojejunal anastomosis, occurring in 27 patients (14.4%). Of the 115 patients who underwent surgery more than 1 year previously, 1-year follow-up data were available for 93 (81%). The body mass index (weight in kilograms divided by the square of height in meters) decreased from 53 ± 8 preoperatively to 35 ± 6 at 1 year. The mean ± SD percentage of excess body weight lost at 1 year was 61% ± 14%. Diabetes mellitus was negatively correlated with percentage of excess body weight lost at 1 year (P = .06).
Surgeon experience, sleep apnea, and hypertension are associated with complications after laparoscopic RYGB. Diabetes mellitus may be associated with poorer post-operative weight loss.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources