Laparoscopic Roux-en-Y Gastric Bypass: Evolution of Weight Loss and Metabolic Obesity-Related Complications After...

Roux-en-Y gastric bypass (RYGB) is one of the prevailing metabolic/bariatric surgical (MBS) procedures. It has been used for > 50 years, yet few long-term results (> 10 years) have been published. The aim of this study is to report 15-year results and beyond in a large patient group regarding weight loss, metabolic outcomes and long-term morbidity.

Our prospective bariatric database was reviewed and analyzed retrospectively. All patients who underwent primary laparoscopic RYGB between 1999 and 2008 were included. Data was gathered during in-person visits for most patients, but also using electronic medical records, phone calls to patients and/or general practitioners.

Nine hundred forty-four patients underwent RYGB during the study period. All were eligible for follow-up after 15 years, and 340 were eligible after 20 years. 39 (4.1%) patients died during the first 15 postoperative years. Follow-up rates were 91.7%, 74.5% and 52.3% after 10, 15 and 20 years respectively. Weight loss peaked after 2 years when total weight loss (TWL) reached 35.1%. TWL was 28.6%, 28.4% and 26.7% after 10, 15 and 20 years. Mean body mass index decreased from 45.7 kg/m² to 29.5, 32.5, 32.7 and 34.6 after 2, 10, 15 and 20 years respectively. Metabolic status remained improved after 20 years (reduced fasting glycemia, better lipid profile and lowered serum urates).

RYGB is an efficient MBS procedure, associated with sustained weight loss and improvement of metabolic complications; a slight worsening occurs over time, partly attributed to aging and the chronic course of obesity and related metabolic disorders.