Weight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 Years
Other long-term studies (>10-year follow-up) do not confirm the late failure rates herein reported. Hess et al6 were able to follow 167 of 182 patients (92%) more than 10 years after biliopancreatic diversion with duodenal switch. They found 87 (52%) had lost at least 80% of excess weight. Only 6% lost less than 50% of excess weight.6 We found that 55 of 161 (34%) of our patients had lost at least 80% of excess weight after more than 10 years follow-up. Hess et al report a mean initial excess weight loss of 75% (no SD reported) for patients followed for more then 10 years.6 This compares with 68.6% ± 21.4% (mean ± SD) reported by Biron et al5 and 67.6% ± 25.1% (mean ± SD) reported herein for the gastric bypass operation.
Fobi et al8 using the transected banded gastric bypass followed 22 of 51 patients for 10 years and reported a mean of 72% excess weight loss, but no range (eg, mean ± SD) of results or stratification based on preoperative weight was supplied. Their data are similar to ours with 67.6% excess weight loss at >10 years follow-up.
Pories et al9 showed a remarkable stability of postoperative weight after gastric bypass for up to 14 years. Their study of 608 patients with a 97% follow-up showed a 58% loss of excess weight after 5 years and a BMI of 33.7. After 10 years, the excess weight loss was 55% and the BMI was 34.7 (range, 22.5–64.7). At 14 years (10 patients), the EWL was 49% and the BMI 34.9 (range, 25.9–54.6). Since only 158 of the 608 patients in this series were followed for 10 years, late weight gain may be missed.