Surgical treatment of morbid obesity. A survey of overall outcome 1968-1989.
This survey evaluates benefits and costs from a policy of employing surgical treatment in selected cases of morbid obesity. Between 1968 and 1978, we used end-to-side jejunoileal bypass. Despite many satisfied patients, complications were frequent and severe. For the next decade, we employed various types of gastric surgery. We eventually assessed a gastric balloon, but without success. Median duration of follow-up was 132 months in 145 patients with jejunoileostomy, 103 months in seven gastric bypass patients, and 36 months in 108 gastroplasty patients. Three patients were lost to follow-up. There have been four deaths after intestinal shunt and one after gastroplasty. The median re-admission rate was 1.6 per patient, while the median number of re-operations was 2.0 after intestinal shunt and 0.8 after gastric interventions. The median weight loss in our 260 patients was 32.1% of the preoperative weight. Outcome was good in 38.8%, acceptable in 40.4% and poor in 11.5% while there were 9.2% failures. Truly satisfactory outcomes, however, were rare, owing possibly to a negative relationship between weight loss and complications. Only 8.8% have obtained a stable normal weight without any side-effects.
Gjørup
I E
IE
Department of Surgical Gastroenterology D, Herlev Hospital.
Gøtzsche
P C
PC
Baden
H
H
Andersen
B
B
D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects; D015391:Gastroplasty / Q000009:adverse effects; D006801:Humans; D007581:Jejunoileal Bypass / Q000009:adverse effects; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D015431:Weight Loss