Laparoscopic mini-gastric bypass in patients age 60 and older
Bariatric surgery in patients over age 60 was previously not considered, due to higher risk. The author presents a study of patients ≥60 years who underwent laparoscopic mini-gastric bypass (LMGB), to evaluate outcomes with follow-up to 6 years.
From 2007–2013, a prospectively maintained database was reviewed and patients ≥60 years were identified. Demographics evaluated included age, sex, weight, BMI, comorbidities, operative time, complications, length of stay (LOS) and %EWL up to 72 months.
From 2007–2013, a total of 758 LMGBs were performed by one surgeon (CP). Eighty-eight (12 %) were ≥60 years old, with 62 % female. Mean age of this cohort at operation was 64 (60–74), and mean weight and BMI were 118 kg (78–171) and 43 kg/m2 (33–61), respectively. Comorbidities were present in all patients, and one-third had previous abdominal operations. All patients underwent LMGB, without conversion to open. Mean operative time was 70 min (43–173). Only one patient required overnight ICU admission. Average LOS was 1.2 days (1–3). Overall complication rate was 4.5 % (all minor); there were no major complications. Readmission rate was 1.2 % (one patient). There was no surgical-related mortality. Follow-up to 90 days was 89 %, but steadily declined to 42 % at 6 years (72 months). The %EWL was 72 % at 72 months.
LMGB can be safely performed with good weight loss in patients ≥60 years old, despite numerous comorbidities and previous abdominal operations.
KeywordsLaparoscopic Bariatric surgery Mini-gastric bypass Medicare
The author is grateful to Mervyn Deitel, MD, FASMBS, FACN, CRCSC for suggestions with the study and manuscript.
Cesare Peraglie has no conflicts of interest or financial ties to disclose.
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