Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up

Abstract

Background: The short-term benefits of bariatric surgery are well documented; however, few reports with data beyond 10 years exist. Those that have been published have described only open procedures. We present our 10-year follow-up results with laparoscopic Roux-en-Y gastric bypass with hand-sewn gastrojejunal anastomosis in a group private practice.

Methods: We performed an institutional review board-approved retrospective review of a prospectively maintained database, combined with office visits and telephone questionnaires, for patients who underwent laparoscopic Roux-en-Y gastric bypass between February 1998 and April 1999.

Results: A total of 242 patients underwent surgery from February 1998 to April 1999. The office follow-up rate was 33% at 2 years and 7% at 10 years. An additional 19% had telephone follow-up at 10 years. The mean excess weight loss was 57% at 10 years. Of the 242 patients, 65 (33.2%) failed to achieve an excess weight loss of >50%; 86 (35%) had ≥1 complication during follow-up. However, 83%, 87%, 67%, and 76% of patients with diabetes, hypertension, dyslipidemia, and obstructive sleep apnea, respectively, experienced improvement or resolution. The internal hernia rate was 16%, and the gastrojejunal stenosis rate was 4.9%. No surgery-related deaths occurred. Of the 242 patients, 136 (51%) had nutritional testing at least once after postoperative year 1. Of these 136 patients, only 24 (18%) had remained nutritionally intact during follow-up.

Conclusion: The obstacles to follow-up have continued to impede the collection of accurate long-term data. Of the 26% of patients with data, laparoscopic Roux-en-Y gastric bypass provided sustainable weight loss and resolution of co-morbidities. However, nutritional deficiencies presented sporadically over time and underscore the importance of routine testing.