title: Perioperative morbidity, mortality and early outcome of the first 360 gastric bypass operations performed in a district hospital.
abstract: OBJECTIVE
  We report the results for the first consecutive 360 Roux-en-Y gastric by-pass (RYGB) operations performed in a district hospital in Finland.
  
  
  METHODS
  Demographic data, perioperative characteristics, and follow-up data were entered prospectively in the hospital's database for bariatric patients.
  
  
  RESULTS
  We performed 325 primary laparoscopic Roux-en-Y gastric bypass (LRYGB) operations, one open RYGB, and 34 revisions. Mean BMI before the operations was 47.5 ± 7.8 kg/m2 (31.5-91.0 kg/m2). The percentage of patients with type 2 diabetes mellitus (T2DM) was high; 52.3% (170 patients). The mean operative time decreased from 110 minutes during the first 108 operations to 82 minutes for the second 108 operations, and to 74 minutes for the last 109 operations (P < 0.001). Postoperative hospital stay was significantly reduced (P < 0.001) for the last 109 patients compared to the first and second group of patients. Overall morbidity averaged 19.1% (62/325). Severe complications were detected in 15 patients (4.6%). There was a tendency to more serious complications in the first group of patients. There was one death (mortality 0.3%). With a follow-up rate of 97% at 3 months T2DM had resolved in 48.2%, and had resolved or improved in a minimum of 92.9% of the diabetic patients. Weight loss (WL) and excess weight loss (EWL) averaged 20% and 46% respectively.
  
  
  CONCLUSIONS
  Operative time and postoperative hospital stay decrease significantly with increasing experience. The first one hundred patients may be at higher risk for complications. LRYGB operations may have an important impact on the resolution of T2DM in the operated population.
authors.affiliation: Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, Finland. mikael.victorzon@vshp.fi
authors.forename: M
authors.initials: M
authors.lastname: Victorzon
authors.forename: P
authors.initials: P
authors.lastname: Peromaa-Haavisto
authors.forename: P
authors.initials: P
authors.lastname: Tolonen
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005387:Finland; D015390:Gastric Bypass / Q000379:methods / Q000401:mortality; D006767:Hospitals, District; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D016896:Treatment Outcome; D015431:Weight Loss