The incidence of severe obesity and its co-morbidities are growing all over the world. Good long term results can be achieved in only in 5% of the patients by conservative treatment, so bariatric surgical procedures to decrease body weight are more often applied recently. The most often performed bariatric surgical intervention is the laparoscopic Roux-en-Y gastric bypass, which effectively decreases body weight in addition to having a favourable effect on the relatively frequent co-morbidities associated with severe obesity (such as diabetes type II, hypertension, gastro-esophageal reflux and locomotor diseases).
Method: The authors report the results of 47 patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) and details of the applied surgical procedure are also described. The indication was a Body Mass Index (BMI) higher than 40 kg/m2 and with type II diabetes and severe gastro-esophageal reflux with BMI higher than 35. During the intervention a gastric pouch of 50 ml, an alimentary loop of 1.5 m and a bilio-pancreatic loop of 1 m in length were prepared. Data were collected from our hospital database and questionnaires filled in by the patients after a mean follow-up period of 15.7 months.
Results: The mean loss of weight was 51.9 kg, patients gave up 88% of their extra weight. 10 patients suffered from type II diabetes, after the intervention 9 of them became normoglycaemic without diet and medical treatment. The rate of the hypertension, GER and locomotor diseases were significantly improved. There was no mortality and anastomotic insufficiency. 94% of the patients were satisfied with the post-operative results.
Discussion: The LRYGB is an effective bariatric surgical procedure that affects favourably type II diabetes, hypertension, GER and locomotor diseases. As regards the biochemical background of the beneficial effects of this surgical intervention on the diabetes further examinations are necessary.