[Therapeutic failures after gastric bypass operations for morbid obesity].
BACKGROUND
Although gastric bypass is an effective treatment for morbid obesity, the postoperative results are unsatisfactory in 10% of all patients. Therapeutic failures after an operation performed with the sole purpose of reducing the risk of obesity-associated diseases have to be taken seriously. The goal of this study was to investigate the causes of these failures.


METHODS
From 1979 to 1993, 165 gastric bypass operations (technique: Mason-Griffen) were performed. Long-term results were obtained in 60 patients after an average of 6.6 years (range 3-13). On follow-up all patients were examined and asked about their level of satisfaction with the weight loss achieved and changes in eating habits.


RESULTS
In 6 patients the weight reduction was regarded as insufficient (BMI > 35 and reduction of BMI < 10). The causes of these failures were technical in 3 cases (gastric pouch to 0 large in 1, dilatation of gastrojejunostomy in 2). Three patients had a high calorie intake through an intact gastric bypass by snacking. Three patients regarded the operation as a failure although they had achieved significant weight loss, because they could no longer eat the usual amounts of food.


CONCLUSIONS
Correct surgical technique and preoperative information on the changes in eating habits after a gastric bypass operation are the most important steps in preventing therapeutic failures.
Kriwanek
S
S
Chirurgische Abteilung, Krankenanstalt Rudolfstiftung, Wien.
Beckerhinn
P
P
Blauensteiner
W
W
Dittrich
K
K
Armbruster
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002149:Energy Intake / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D017211:Treatment Failure; D015431:Weight Loss / Q000502:physiology
Therapeutische Misserfolge nach Magenbypassoperationen wegen morbider Fettsucht.