Weight reduction after an early version of the open gastric bypass for morbid obesity: results after 23 years.
BACKGROUND
While numerous promising short-term results of open gastric bypass for morbid obesity were published, the long-term outcome of earlier versions was somewhat disappointing. Thus, it was not until 1993 that this procedure was reintroduced with current modifications and now performed laparoscopically. Published long-term results of gastric bypass are still lacking.


METHODS
Out of an original population of 195 patients, we retrospectively analyzed the outcome of 98 patients (82 women, 16 men, mean age 32 years [range 17-54], mean weight 132 kg [range 65-200], mean BMI 46.6 kg/m2) operated on in Erlangen with mean follow-up 22.9 years (range 16.5-25.4). 3 different bariatric operations were performed: horizontal gastroplasty (HGP, n=18), stapled Roux-en-Y gastric bypass (S-RYGBP, n=14) and transected Roux-en-Y gastric bypass (T-RYGBP, n=66). BMI and percentage of excess weight loss (%EWL) were calculated at time 0, and after 1, 2, 3, 10, 15, 20 and 25 years.


RESULTS
Statistically significant weight loss was found for the whole patient population at every postoperative time-point compared to preoperative values. Maximal weight loss was achieved mainly during the first 3 years. However, initial and long-term outcome after HGP was significantly worse than after S-RYGBP or T-RYGBP. Gender did not significantly influence the results.


CONCLUSIONS
Traditional open gastric bypass resulted in acceptable and safe long-term weight reduction. It may be assumed that laparoscopic gastric bypass with modern tiny pouch volumes based on the lesser curvature achieves even better and life-long weight reduction.
Department of Surgery, Clinical Center of Fürth, Germany. klaus.guenther@rzmail.uni-erlangen.de
Klaus
K
Günther
Jörg
J
Vollmuth
Rafael
R
Weissbach
Werner
W
Hohenberger
Bernhard
B
Husemann
Thomas
T
Horbach
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009767:Obesity, Morbid / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss