Weight reduction after gastric bypass and horizontal gastroplasty for morbid obesity. Results after 10 years.

OBJECTIVE

To evaluate the long term value of gastric bypass and horizontal gastroplasty for the treatment of morbid obesity.

DESIGN

Retrospective study.

SETTING

University hospital.

SUBJECTS

119 patients of 195 who were operated on between 1976 and 1986.

INTERVENTIONS

Horizontal gastroplasty (n = 15), transected gastric bypass (n = 83), or stapled gastric bypass (n = 21).

MAIN OUTCOME MEASURES

Weight loss, reduction in body mass index, and morbidity.

RESULTS

Mean (SD) body weight (kg) after gastroplasty decreased from 139 (20) to 112 (14) at one year, but had increased to 130 (22) at 10 years. The corresponding figures for transected gastric bypass were 134 (24), 95 (20), and 103 (22); and for stapled gastric bypass 137 (27), 100 (24), and 112 (23). The figures for body mass index showed a similar pattern. Three quarters of the patients developed physical or psychological complications after the operation that were related to either the obesity or the operation, or both.

CONCLUSIONS

None of the three operations provided adequate or prolonged control of morbid obesity, and the morbidity was high. Too large a proximal pouch, or disruption of the line of staples, may have been responsible.