Subtotal gastric exclusion and gastric partitioning: a randomized prospective comparison of one hundred patients

A randomized prospective comparison of 50 modified Gomez gastric partitioning to 50 subtotal gastric exclusion (bypass) operations is presented. Smaller pouch sizes than are generally recommended were used, along with accurate calibration of the outlet size by suturing around a 30F bougie in both operations. It is believed that these techniques improved weight loss with minimal increase in side effects, but some increase in the length of hospital stay to ensure adequate fluid intake. Significantly better weight loss and less need for reoperation was found with gastric exclusion, and the complication rates were similar. Either operation requires meticulous attention to detail and follow-up to achieve low mortality and morbidity rates and good weight loss; but, if these are accomplished, the best end results statistically strongly favor subtotal gastric exclusion.