[One thousand bariatric interventions]

Bariatric surgery is the most effective treatment for morbid obesity. The aim of the present study was to evaluate changes over 29 years of personal experience and in bariatric surgery in general.

One thousand patients underwent surgery from 06-17-1977 to 11-12-2005. Procedures consisted of open gastric bypass (GBP) in 16, vertical banded gastroplasty (VBG) in 129, laparoscopic gastric banding in 3, duodenal switch (DS) in 526, laparoscopic gastric bypass (LGBP) in 44, laparoscopic DS (LDS) in 240 and laparoscopic sleeve gastrectomy (LSG) in 43.

Eleven patients died (1.1%): causes were pulmonary embolism in 4 (0.4%), pericardial tamponade in 1, rhabdomyolysis in 1, and multiorgan failure in 5 (0.5%) (1 after intraabdominal bleeding, 4 due to leaks and sepsis). Major morbidity occurred in 60 patients (6%) consisting of leaks in 49 (4.9%), rectal abscesses in 3, intraabdominal abscesses in 3, and intraperitoneal hemorrhages in 5 (0.05%). Minor morbidity occurred in 71 patients (7.1%). Ten patients died in the long-term (1%). The percentage of excess body mass index lost at 5 years was 66.4 in patients with gastroplasty, 78.8 in those with DS and 69.3 in those with gastric bypass.

Bariatric surgery is highly effective and widely accepted among patients and medical centers in Spain, in which the number of publications and mortality (<1%) are acceptable. Most patients undergo laparoscopic surgery.