Bariatric surgery in patients older than 65 years is safe and effective.
BACKGROUND
To review the short-term safety and efficacy of the laparoscopic adjustable gastric band (LAGB) and laparoscopic gastric bypass (GBP) in patients older than 65 years.


METHODS
A single-institution review of all bariatric procedures was performed.


RESULTS
Twenty-seven patients were identified. Of the 27 patients, 13 underwent primary GBP and 14 underwent LAGB placement. The average age was 68.1 +/- 2 years (range 65-73). The average follow-up for the GBP group and LAGB group was 9.3 months (range 1-21) and 19.6 months (range 4-31), respectively. One minor (stricture) complication and zero major complications occurred in the GBP group. In the LAGB group, one minor complication (port fracture) and one major complication (total weight loss failure requiring conversion to GBP) occurred. The percentage of excess weight loss at 1 year for the GBP group was 71%. At 1 and 2 years, it was 32% and 35%, respectively, for the LAGB group. Only in the GBP group did patients have a significant decrease in medication use and in the number of comorbidities. Quality-of-life measurements improved equally after both procedures. Weight loss was no different after GBP surgery regardless of age, but older LAGB patients had a 12% decrease in the expected excess weight lost (P < 0.05).


CONCLUSIONS
Bariatric surgery can be performed with acceptable safety, excellent weight loss, resolution of comorbidities, and significant improvement in quality of life in patients older than 65 years. The GBP seems to be as safe as, and more effective than, the LAGB in this age group.
Quebbemann
Brian
B
The NEW Program, Orange County, CA 92647, USA.
Engstrom
David
D
Siegfried
Trace
T
Garner
Karen
K
Dallal
Ramsey
R
D000367:Age Factors; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D016014:Linear Models; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome