Laparoscopic resectional gastric bypass: initial experience in morbidly obese Korean patients

Abstract

Purpose Roux-en-Y gastric bypass (RYGB) is thought to be the gold standard treatment for morbid obesity. However, concerns have been raised by investigators in areas where gastric cancer is prevalent regarding the inaccessibility of the excluded stomach to regular surveillance. This study aimed to evaluate the technical feasibility and short-term surgical outcomes of resectional RYGB. Methods Sixteen consecutive patients who underwent laparoscopic gastric bypass with distal gastric resection for the primary purpose of weight loss between January 2011 and December 2013 were retrospectively reviewed. The perioperative outcomes and weight loss results of these patients were analyzed. Results All procedures were successfully performed laparoscopically. The mean length of the operation and the mean hospital stay were 170 min (range 110-225) and 4 days (range 2-7), respectively. The prevalence of early postoperative complications reached 18.7 % after resectional RYGB, but a severe complication requiring reoperation occurred in only one patient (6.3 %). The percent of excess weight loss was 78.9 % over a mean follow-up period of 14 months. Obesity-related comorbidities including diabetes, hypertension and dyslipidemia resolved or improved after surgery in most patients. Conclusion Resectional RYGB is technically feasible and can be a viable option in countries with a high risk of gastric cancer, where surgeons are already well trained in laparoscopic gastrectomy.