Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity

Mayo Clin Proc. 2000 Jul;75(7):673-80. doi: 10.4065/75.7.673.


Objective: To determine prospectively the results of Roux-en-Y gastric bypass (RYGB) used as the primary weight-reducing operation in patients with medically complicated ("morbid") obesity. The RYGB procedure combines the advantages of a restrictive physiology (pouch of 10 mL) and a "dumping physiology" for high-energy liquids without requiring an externally reinforced (banded) stoma.

Patients and methods: Between April 1987 and December 1998, a total of 191 consecutive patients with morbid obesity (median weight, 138 kg [range, 91-240 kg]; median body mass index, 49 kg/m2 [range, 36-74 kg/m2]), all of whom had directly weight-related morbidity, underwent RYGB and prospective follow-up.

Results: Hospital mortality was 0.5% (1/191), and hospital morbidity occurred in 10.5% (20/191). Good long-term weight loss was achieved, and patients adapted well to the required new eating habits. The mean +/- SD weight loss at 1 year after operation (113 patients) was 52 +/- 1 kg or 68% +/- 2% of initial excess body weight. By 3 years postoperatively (74 patients), weight loss was still 66% +/- 2% of excess body weight. Overall, 53 (72%) of 74 patients had achieved and maintained a weight loss of 50% or more of their preoperative excess body weight 3 years after the operation. In addition, only 1 (1%) of 98 patients had persistent postoperative vomiting 1 or more times per week.

Conclusion: We believe that RYGB is a safe, effective procedure for most patients with morbid obesity and thus may be the current procedure of choice in patients requiring bariatrics++ surgery for morbid obesity.

MeSH terms

  • Adaptation, Physiological
  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Roux-en-Y* / adverse effects
  • Body Mass Index
  • Body Weight
  • Evaluation Studies as Topic
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Gastric Bypass / adverse effects
  • Gastric Bypass / methods*
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Patient Satisfaction
  • Postoperative Complications
  • Postoperative Nausea and Vomiting / etiology
  • Prospective Studies
  • Safety
  • Survival Rate
  • Treatment Outcome
  • Weight Loss