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Obesity Surgery
Published in: Obesity Surgery 10/2015

Open Access 01-10-2015 | Original Contributions

Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m2—A Double-Blind, Randomized Controlled Trial

Authors: Marius Svanevik, Hilde Risstad, Dag Hofsø, Carl Fredrik Schou, Brita Solheim, Torgeir T. Søvik, Jon Kristinsson, Jøran Hjelmesæth, Tom Mala, Rune Sandbu

Published in: Obesity Surgery | Issue 10/2015

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Abstract

Background

Proximal Roux-en-Y gastric bypass may not ensure adequate weight loss in superobese patients. Bypassing a longer segment of the small bowel may increase weight loss. The objective of the study was to compare the perioperative outcomes of laparoscopic proximal and distal gastric bypass in a double-blind randomized controlled trial of superobese patients. The study was conducted at two public tertiary care obesity centers in Norway.

Methods

Patients with body mass index (BMI) 50–60 kg/m2 were randomly assigned to a proximal (150 cm alimentary limb) or a distal (150 cm common channel) gastric bypass. The biliopancreatic limb was 50 cm in both operations. Patients and follow-up personnel were blinded to the type of procedure. Thirty-day outcomes including complications are reported.

Results

We operated on 115 patients, of whom two were excluded at surgery, leaving 56 and 57 patients in the proximal group and distal group, respectively. The median (range) operating time was 72 (36–151) and 101 (59–227) min, respectively (p < 0.001). Two distal procedures were converted to laparotomy during the primary procedure. Median length of hospital stay was 2 (1–4) days in the proximal group and 2 (1–24) days in the distal group. The number of patients with complications and complications categorized according to the Contracted Accordion classification did not differ significantly. However, all six reoperations were performed in the distal group, of which three were completed by laparoscopy (p = 0.01 between groups). There were no deaths.

Conclusions

In superobese patients with BMI between 50 and 60 kg/m2, distal gastric bypass was associated with longer operating time and more severe complications resulting in reoperation than proximal gastric bypass.
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Metadata
Title
Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m2—A Double-Blind, Randomized Controlled Trial
Authors
Marius Svanevik
Hilde Risstad
Dag Hofsø
Carl Fredrik Schou
Brita Solheim
Torgeir T. Søvik
Jon Kristinsson
Jøran Hjelmesæth
Tom Mala
Rune Sandbu
Publication date
01-10-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1621-y

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