Roux-en-Y Gastric Bypass: Ten-year Results in a Cohort of 658 Patients

Ann Surg. 2018 Dec;268(6):1019-1025. doi: 10.1097/SLA.0000000000002538.


Objective: The aim of this paper is to report, with a high follow-up rate, 10-year results in a large cohort of patients after Roux-en-Y gastric bypass (RYGBP) done essentially by laparoscopy.

Background: RYGBP has been performed for 50 years, including 20 years by laparoscopy, yet very few long-term results have been reported, mostly after open surgery.

Methods: Prospective bariatric database established since the introduction of bariatric surgery. Retrospective data analysis on weight loss, long-term complications, quality of life, and comorbidities.

Results: In all, 658 consecutive patients (515 women/143 men) were included: 554 with primary RYGBP, 104 with reoperative RYGBP. There was 1 (0.15%) postoperative death. Thirty-two (5%) patients died during follow-up from causes unrelated to surgery. Ten years after primary RYGBP, patients lost 28.6 ± 10.5% of their initial weight, corresponding to a mean of 13.2 body mass index (BMI) units. Among them, 72.8% achieved a BMI <35. Weight loss ≥20% was seen in 80.3% and <10% in 3.9% of patients. Results were similar in patients undergoing primary or reoperative RYGBP, but were better in patients who were initially less obese (BMI <50 kg/m) than in superobese patients. Quality of life and comorbidities significantly improved with 80% resolution or improvement of metabolic comorbidities. All patients required supplementations, and 14.6% required long-term reoperation.

Conclusions: RYGBP provides long-term satisfactory weight loss up to 10 years, and significantly improves quality of life and comorbidities. Long-term complications requiring reoperation can develop. Mineral and vitamin supplementation are universally necessary. Other more effective surgical options should be discussed in patients with very severe obesity.

MeSH terms

  • Adult
  • Anastomosis, Roux-en-Y / methods*
  • Comorbidity
  • Female
  • Gastric Bypass / methods*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Obesity, Morbid / surgery*
  • Postoperative Complications
  • Quality of Life
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss