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Short and Long-Term Results of Gastric Bypass,[object Object],Samer G. Mattar, MD, FRCS, FACS,[object Object],Associate Professor of Surgery,[object Object],Indiana University,[object Object]
Short and long term results of gastric bypass
BOLD ,[object Object],57,918 patients,[object Object],> 800 surgeons in > 450 facilities.,[object Object],31,668 patients (54.7%) had gastric bypass.,[object Object],Complication rate = 14.9%,[object Object],All mortality rate = 0.14%,[object Object],DeMaria EJ et al. SurgObesRelDis 2010;6(4):347-55,[object Object]
Long-Term Weight Loss for Gastric Bypass,[object Object],Mean BMI: 52,[object Object],Follow-up >90%,[object Object],Nadir Wt. Loss: 65% EWL,[object Object],Mean Wt. Loss at 14 years: 49% EWL,[object Object]
COMPARISON OF BARIATRIC OPERATIONS,[object Object],n = 22,094 patients; 2738 citations 1990-2002,[object Object],Buchwald, et al JAMA 2004;292:1724-1737,[object Object],Brethauer et al. SOARD 2009 (4): 469-475,[object Object]
LONG-TERM SURVIVAL CANADA,[object Object],Rel. Risk = 0.11 (.04-.27),[object Object],89% reduction in risk ofdeath over 5 years,[object Object],Christou et al. Ann Surg 2004;240:416-424,[object Object]
Results:Five Year Comorbidity,[object Object],*,[object Object],*,[object Object],*,[object Object],*,[object Object],*,[object Object],*p<0.001,[object Object],Christou et al. Ann Surg 2004;240:416-424,[object Object]
Results:Five Year Comorbidity,[object Object],*,[object Object],*,[object Object],*,[object Object],Christou et al. Ann Surg 2004;240:416-424,[object Object]
Swedish Obese Subjects Study SOS,[object Object],Prospective matched controlled study.,[object Object],641 surgically treated subjects and 627 obese controls.,[object Object],10 year follow up.,[object Object],Surgical therapies consisted of:,[object Object], 			- fixed or variable banding,[object Object],			- vertical banded gastroplasty,[object Object],			- gastric bypass,[object Object],Sjostrom et al, NEJM 2004; 351(26): 2683-93,[object Object]
10 years results of Bariatric Surgery,[object Object],n=1268 (641 surgery),[object Object],Sjöström et al. N Eng J M Dec 2004;351(26):2751-3  ,[object Object]
EFFECT OF GBP ONTYPE 2 DIABETES MELLITUS*,[object Object],					Before	     After				       Operation      Operation,[object Object],Glucose Impaired		53            	0	,[object Object],Type 2 Diabetes          		88              	2,[object Object],    Receiving Insulin        	20            	10,[object Object],	 Oral Agent                  	13		0		,[object Object],Pories WJ et al. Ann Surg 1995;222:339-50,[object Object]
Observations in DM2,[object Object],Early surgical intervention is the most effective treatment for T2DM ,[object Object],Results in significant reduction in medication requirement  ,[object Object],Resolution dependent on preoperative duration and severity of T2DM, and on ultimate weight loss,[object Object]
Conclusions,[object Object],Gastric bypass continues to be the dominant weight loss operation in the US.,[object Object],Center of Excellent data demonstrates a morbidity rate of 14% and an overall  mortality rate of 0.14%.,[object Object],The effects of gastric bypass are durable.,[object Object],Gastric bypass results in 89% reduction in risk of early death.,[object Object],Early surgical intervention is the most effective treatment for DM2,[object Object]
Thank you!,[object Object]

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Short and long term results of gastric bypass

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