Weight reduction after gastric bypass and horizontal gastroplasty for morbid obesity. Results after 10 years.

Objective: To evaluate the long term value of gastric bypass and horizontal gastroplasty for the treatment of morbid obesity.
Design: Retrospective study.
Setting: University hospital.
Subjects: 119 patients of 195 who were operated on between 1976 and 1986.
Interventions: Horizontal gastroplasty (n = 15), transected gastric bypass (n = 83), or stapled gastric bypass (n = 21).
Main Outcome Measures: Weight loss, reduction in body mass index, and morbidity.
Results: Mean (SD) body weight (kg) after gastroplasty decreased from 139 (20) to 112 (14) at one year, but had increased to 130 (22) at 10 years. The corresponding figures for transected gastric bypass were 134 (24), 95 (20), and 103 (22); and for stapled gastric bypass 137 (27), 100 (24), and 112 (23). The figures for body mass index showed a similar pattern. Three quarters of the patients developed physical or psychological complications after the operation that were related to either the obesity or the operation, or both.
Conclusions: None of the three operations provided adequate or prolonged control of morbid obesity, and the morbidity was high. Too large a proximal pouch, or disruption of the line of staples, may have been responsible.