Short-term results of laparoscopic gastric bypass in patients with BMI ≥60

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been shown to be safe and effective. Little information is available about the subgroup of patients with BMI greater than or equal to60. The goal of this study was to evaluate the feasibility and safety of LRYGBP for patients' with BMI greater than or equal to60. Methods: The study consisted of the first 300 attempted LRYGBPs performed by one surgeon. (HJS). This population was analyzed as 2 groups of patients: those with BMI <60 and those with BMI ≥60. Outcome variables included mortality, complications, conversion, and operative time. Results: Of the first 300 LRYGBP patients, 261 had BMI <60 and 39 had BMI greater than or equal to60. Age, comorbidity rate, and gender distribution were similar in both BMI groups. Conversion rates were <3% in both groups. Mean operative time for the BMI ≥60 group was 156 minutes vs 139 minutes in the lighter group (P = 0.04). Major complications occurred more commonly in the BMI ≥60 group (10% vs 6%) but this difference was not significant. The types of complications differed between the 2 groups, with infectious complications and gastrointestinal leak occurring more frequently in the heavier group. The mortality rate was higher in the heavier group (5% vs 0.4%, P = 0.055). Conclusion: LRYGBP is feasible for patients with BMI ≥60. Our data suggest that these patients are at a higher risk for GI leak, postoperative infection, and death.