Background:Laparoscopic RYGB simultaneously causes food malabsorption and restricts food intake and generally results in more weight loss than restrictive operations, including the Lap-Band gastroplasty. Patients who have laparoscopic RYGB generally lose about two-thirds of their excess weight in 2 years and within 3 years they lose 68-72% of excess weight. At ten years, most patients continue to keep off at least 50% of the excess weight.Long-term complications include pouch stretching, and gastrojejunal anastomotic strictures. Because gastric bypass operations cause food to skip the duodenum, risks for nutritional deficiencies are higher than for restrictive procedures. Anemia may result from malabsorption of vitamin B12 and iron in menstruating women, and decreased absorption of calcium may bring on osteoporosis and bone disease. Long-term complications may also include deficiencies in vitamins A, D, E, Bl, B6, and folic acid. Patients must take nutritional supplements daily to manage these side effects.
Patients and methods: The study consisted of 40 patients operated upon from January 2005 to September 2009 with minimal follow up of 6 months. Patients, who are operated before May
2008, were 20 patients and they were studied retrospectively. Prospective study was conducted on 20 patients who were operated on from May 2008.
Results: Nineteen patients (57.5%) developed late complications (>30 days). One patient
developed myocardial ischemia (2.5%)which was treated by stent and resolved, 3 patients developed prolonged nausea (7.5%) which resolved spontaneously, 2 patients (5%) developed repeated vomiting which resolved spontaneously, 2 patients developed gastrojejunostomy anastomotic stricture (5%) which resolved after endoscopic balloon dilatation, one patient (2.5%) developed symptomatic gall stones and was treated by laparoscopic cholecystectomy, one patient developed marginal ulcer(2.5%) and was treated by proton pump inhibitors and resolved. One patient developed depression and he was normal preoperatively, however he received medications and improved. One patient developed incisional hernia (2.5%) at trocar site which was repaired. Six patients (15%) developed iron deficiency anemia and were treated by iron. One patient (2.5%) developed protein-calorie malnutrition and improved with TPN and dietary counseling.
Conclusions: The important outcome related to the goal ofbariatric surgery such as weight loss, important reduction in comorbidities and good quality of life results in this study appear acceptable if compared with other series.