Short-term results of laparoscopic gastric bypass in patients with BMI > or = 60.
BACKGROUND
Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been shown to be safe and effective. Little information is available about the subgroup of patients with BMI > or = 60. The goal of this study was to evaluate the feasibility and safety of LRYGBP for patients with BMI > or = 60.


METHODS
The study consisted of the first 300 attempted LRYGBPs performed by one surgeon (HJS). This population was analyzed as 2 groups of patients: those with BMI < 60 and those with BMI > or = 60. Outcome variables included mortality, complications, conversion, and operative time.


RESULTS
Of the first 300 LRYGBP patients, 261 had BMI < 60 and 39 had BMI > or = 60. Age, comorbidity rate, and gender distribution were similar in both BMI groups. Conversion rates were < 3% in both groups. Mean operative time for the BMI > or = 60 group was 156 minutes vs 139 minutes in the lighter group (P = 0.04). Major complications occurred more commonly in the BMI > or = 60 group (10% vs 6%) but this difference was not significant. The types of complications differed between the 2 groups, with infectious complications and gastrointestinal leak occurring more frequently in the heavier group. The mortality rate was higher in the heavier group (5% vs 0.4%, P = 0.055).


CONCLUSIONS
LRYGBP is feasible for patients with BMI > or = 60. Our data suggest that these patients are at a higher risk for GI leak, postoperative infection, and death.
Oliak
David
D
Department of Surgery, Hackensack University Medical Center, Hackensack, NJ, USA. daveoliak@yahoo.com
Ballantyne
Garth H
GH
Davies
Richard J
RJ
Wasielewski
Annette
A
Schmidt
Hans J
HJ
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D013270:Stomach / Q000601:surgery; D016896:Treatment Outcome