[Is laparoscopic gastric bypass a dangerous procedure during the early phase of the learning curve? A prospective study of the first 50 cases].
BACKGROUND
Among the various bariatric procedures, laparoscopic Roux-en-Y gastric bypass (LRYGBP) is widely considered to be the gold standard. However, a majority of bariatric surgeons in France do not perform LFYGBP, perhaps because of its reputation as a technically demanding procedure with a long learning curve. This study evaluates the outcomes and the learning curve for the first 50 LFYGBP performed by one surgeon in a French non-university hospital.


METHODS
Between April 2007 and February 2009, we performed our first 50 cases of LRYGBP. Surgical outcomes and the learning curve were measured by prospective criteria including length of stay, operative time, complications, percentage weight loss and reduction of obesity-related co-morbidities.


RESULTS
The mean patient age was 41.8+/-9.8 years. The mean BMI was 47.7+/-7.1 kg/m(2). The mean operative time was 146+/-51 minutes and the mean hospital stay was 5.3+/-1.4 days. Three cases (6%) were converted to open surgery. Early complications occurred in 4% and late complications occurred in 6%. The average follow-up was 6.3+/-1.3 months. Overall excess weight loss was 39.5, 50, 62, and 63% at 3, 6, 9, and 12 months.


CONCLUSIONS
LRYGBP can be performed with acceptable morbidity and short-term results, even during the early phase of a surgeon's learning curve. It is a feasible procedure for bariatric surgeons with previous experience in gastric banding.
Keller
P
P
Département de chirurgie, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue de la Liberté, 68024 Colmar cedex, France. philippe.keller@ch-colmar.rss.fr
Romain
B
B
Nicolae
M-A
MA
Perrin
P
P
Meyer
C
C
D000328:Adult; D050110:Bariatric Surgery / Q000193:education*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D007858:Learning; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss