Low Complication Rates Following Laparoscopic Gastric Bypass. a Report from the Bariatric Surgery Center of Excellence.

Introduction: Bariatric surgery remains the only modality to provide morbidly obese patients with a significant and sustained weight loss. Laparoscopic Roux-en-Y Gastric Bypass (LRGB) has become the gold standard of bariatric procedures. However significant but variable complication rates following laparoscopic gastric bypass were reported.

Materials and Methods: We present our experience with 434 consecutive patients who underwent LRGB at our institution between August 2001 and October of 2006. All patients met the NIH criteria for bariatric surgery and were operated by a single surgeon using the same technique. All patients and complications data were collected prospectively. A “Complication” was defined as any occurrence affecting uneventful recovery.

Results: There were 387 females (89.2%) and 47 males (10.8%) with an average body mass index (BMI) of 48.3 kg/m2 (range 35-73). Mean length of stay was 3.4 days (1-40) and median hospital stay was 3 days. All operations were completed laparoscopically. The mean operating time was 182 min. and the mean blood loss was 45 cc. There were no major intra-operative complications and no need for intraoperative blood transfusion. There was no peri-operative mortality. There were eight postoperative complications (1.8%) requiring re-operation (GI hemorrhage-4, leak from gastroenterostomy-2, bowel obstruction-2). Another nine patients required additional interventions or longer hospital stay. Forty-nine patients (11.3%) had minor complications responding to conservative treatment. There were no long-term disabilities. Detailed analysis of postoperative complications will be presented.

Conclusion: Establishment of the Bariatric Surgery Center of Excellence assists in achieving low complication rates by promoting the best clinical pathways and best training paradigms for both the surgeon and the institution. Low complication rates that compare favorably with those reported in the literature can be achieved.

Session: Poster

Program Number: P016