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Long-term outcomes following laparoscopic Roux-en-Y gastric bypass: weight loss and resolution of comorbidities at 15 years and beyond

  • 2023 SAGES Oral
  • Published:
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Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the gold-standard bariatric procedure with proven efficacy in morbidly obese populations. While the short-term benefits of LRYGB have been well-documented, durable weight loss and long-term resolution of obesity-related comorbidities have been less clearly described.

Methods

This single-center study prospectively reports weight loss and comorbidity resolution in patients undergoing LRYGB between August 2001 and September 2007 with at least 15-year follow-up. Data were collected at the time of surgery; 1, 3, 6, and 12 months postoperatively; and then annually thereafter.

Results

A total of 486 patients were included in this analysis. Patients were predominantly female (88.7%), and the median age was 36.0 [IQR 29.0–45.0] years. Patients were ethnically diverse, including Black/African American (43.6%), White/Caucasian (35.0%), Hispanic (18.3%), and other backgrounds (3.1%). Mean preoperative weight and body mass index were 133.0 ± 21.9 kg and 48.4 ± 6.5 kg/m2, and the median number of comorbidities was 6.0 [IQR 4.0–7.0]. Follow-up rates at 1, 5, 10, and 15 years were 75.3%, 37.2%, 35.2%, and 18.9%, respectively. On average, maximum percentage total weight loss (%TWL) occurred 2 years postoperatively (− 36.2 ± 9.5%), and ≥ 25% TWL was consistently achieved at 1, 5, 10, and 15-year time intervals (− 28.0 ± 13.0% at 15 years). Patients with comorbidities experienced improvement or resolution of their conditions within 1 year, including type 2 diabetes mellitus (83/84, 98.8%), obstructive sleep apnea (112/116, 96.6%), hypertension (142/150, 94.7%), and gastroesophageal reflux disease (217/223, 97.3%). Rates of improved/resolved comorbidities remained consistently high through at least 10 years after surgery.

Conclusions

LRYGB provides durable weight loss for at least 15 years after surgery, with stable average relative weight loss of approximately 25% from baseline. This outcome corresponds with sustainable resolution of obesity-related comorbidities for at least 10 years after the initial operation.

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Funding

No funding was obtained for this study. None of the authors assume any financial interest or support.

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Authors and Affiliations

  1. Department of Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, 506 Sixth Street, Brooklyn, NY, 11215, USA

    Paul H. McClelland, Mohsin Jawed, Krystyna Kabata, Michael E. Zenilman & Piotr Gorecki

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  1. Paul H. McClelland
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  2. Mohsin Jawed
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  3. Krystyna Kabata
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  4. Michael E. Zenilman
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  5. Piotr Gorecki
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Contributions

PHM and PG conceived the study concept and design. PG provided the clinical material and data. KK and PG verified data accuracy and performed data entry. PHM performed the data analysis. PHM, MJ, and PG prepared the manuscript. MEZ and PG provided critical insight and revision of the manuscript. All authors reviewed the manuscript and gave final approval before submission.

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Correspondence to Paul H. McClelland.

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Paul H. McClelland, Mohsin Jawed, Krystyna Kabata, Michael E. Zenilman and Piotr Gorecki have no conflicts of interest or financial ties to disclose.

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McClelland, P.H., Jawed, M., Kabata, K. et al. Long-term outcomes following laparoscopic Roux-en-Y gastric bypass: weight loss and resolution of comorbidities at 15 years and beyond. Surg Endosc 37, 9427–9440 (2023). https://doi.org/10.1007/s00464-023-10366-6

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