Comparison of weight loss after gastric exclusion and partitioning.

We report follow-up findings after two to almost four years on 100 patients who were described in a previously published prospective randomized series. Horizontally stapled gastric partition (gastroplasty) was compared with gastric exclusion (bypass) using a Roux-en-Y jejunal loop. An additional 142 patients had the identical operative procedures performed during the same time period, but chose their own operation. Both procedures used a small gastric pouch (15 mL) and calibrated 10-mm opening. Weight loss was better after exclusion and has continued to be better. Patients who lose weight well do not regain. There were complications in 8% of the exclusion patients and 12% of the partitioning patients and one death in the exclusion group--0.4% of the total group. Since gastric exclusion is safe and produces significantly better weight loss, we believe it sets the current standard against which all other bariatric surgery must be compared.