Laparoscopic Roux-en-Y gastric bypass surgery in the obesity center Wuerzburg--patient selection and results.

Fein, Martin; Bueter, Marco; Jurowich, Christian; Wierlemann, Alexander; Gerlach, Annette; Thalheimer, Andreas

BACKGROUND The choice between different bariatric procedures for each patient is an important question in bariatric surgery. In this article, we explain criteria for patient selection for laparoscopic Roux-en-Y gastric bypass at the Obesity Center Wuerzburg and compare the corresponding outcomes for these selection criteria. METHODS 60 consecutive patients underwent gastric bypass surgery (34 female, 26 male; mean age 45.1 +/- 10.2 years). Mean preoperative BMI was 53.7 +/- 8.7 kg/m2. Selection criteria were age > 40, male sex,BMI > 50, metabolic syndrome, and/or reduced compliance. RESULTS 42 patients (70%) were >40 years old, 26 patients(43%) were male, 42 patients (70%) had a BMI > 50, and 28 patients had a metabolic syndrome (47%). 10 out of these 60 patients were reoperated after failed gastric banding. Overall weight loss was 43.7 +/- 18.7 kg, BMI loss was 15.0 +/- 6.4 kg/m2,and excess body weight loss (EBWL) was 54.3 +/- 19.7%. There were 34 patients with an EBWL of > or = 50%. Age, sex, and presence or absence of metabolic syndrome were irrelevant for postoperative weight loss. Although the EBWL was slightly higher in patients with a BMI < 50, patients with a BMI > 50 lost significantly more weight. DISCUSSION The indication for a gastric bypass may be substantiated by the higher weight reduction in patients with a BMI > 50. Other selection criteria had no influence on the postoperative outcome.