Weight loss and complications after four gastric operations for morbid obesity

Since April 1975, 292 patients have had gastric operations for morbid obesity: gastric bypass with Roux-en-Y gastrojejunostomy (RY), 105 patients; gastric bypass with loop gastrojejunostomy (loop), 69 patients; greater curvature gastroplasty, 40 patients; and gastric partition with gastrogastrostomy, 78 patients. Follow-up was two years except for the gastrogastrostomy group in which it was one year. Weight loss at one year was 57% for RY, 59% for loop, 65% for gastroplasty, and 46% for gastrogastrostomy. Complications occurred in 27% of the RY patients, 35% of the loop patients, 28% of gastroplasty patients, and 17% of gastrogastrostomy patients. Reoperations were 8% in the gastrogastrostomy group compared to 18% to 28% for the other three groups. In conclusion, after one year the weight loss is less after gastrogastrostomy than after the RY, the loop, and gastroplasty, but the complications are also significantly fewer. It is hoped that recent modifications in gastrogastrostomy will result in weight loss comparable to the other gastric procedures.