Laparoscopic gastric bypass beyond age 60

Previous reports have questioned the safety and efficacy of gastric bypass in older patients. We examine our results in the older group of patients to shed some light on the appropriateness of offering gastric bypass to senior patients.

A retrospective review of a prospectively collected database on all laparoscopic Roux-en-Y gastric bypass (LRYGBP) cases performed from March 2001 to October 2003 was conducted. Patients >60 years of age were compared to the overall group.

A total of 550 patients underwent LRYGBP: all were completed laparoscopically. In the 527 patients <60 years of age, there were no deaths and there were 15 complications (2.8% perioperative morbidity). In the group of patients >60 years old, there were 23 patients; mean age was 64.4 years (60-75 years). There was 1 death in this group (4.3% mortality rate) and 1 postoperative complication (4.3% morbidity rate). In the >60 year group at an average of 12 months follow-up, weight loss was 43.2 kg (28.6-73.2 kg), change in BMI was 16.5 (11-23), and excess weight loss was 65% (40-110%). Also, diabetes resolved in 3 out of 4 patients (75%), obstructive sleep apnea in 2 of 3 (67%), hypercholesterolemia in 3 of 5 (60%) and hypertension resolved or improved in 10 of 11 patients (91%).

While patients >60 years of age had a higher morbidity and mortality, their risk/benefit ratio was acceptable. Older patients achieve significant weight loss and resolution of obesity-associated comorbidities.