Excellent laparoscopic gastric bypass outcomes can be achieved at a community-based training hospital with moderate case volume

Kara J. Kallies, Michelle A Mathiason, Matthew T. Baker

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objective: Our objective was to assess laparoscopic gastric bypass outcomes in a moderate case volume setting. Background: Laparoscopic gastric bypass remains one of the most advanced laparoscopic procedures currently performed worldwide. The following represents a single institutional series from a community hospital-based training program with a minimally invasive bariatric surgical program. Methods: Data from all patients undergoing laparoscopic gastric bypass since the inception of the program were entered into a prospective database. Measured outcomes included length of operation, length of stay, major and minor complications, and percentage excess weight loss. Results were compared with published outcomes from a review of the literature encompassing more than 3400 cases using x2 and Fisher exact tests. Results: Between September 2001 and October 2008, 700 consecutive patients underwent laparoscopic gastric bypass. The mean age was 43.1 ± 9.5 years, and 83% were female. The mean initial weight was 135.5 ± 22.4 kg. The initial body mass index was 47.9 ± 6 kg/m2. The mean length of stay was 2.2 ± 0.9 days. The length of operation was 147.8 ± 31.8 minutes. The mean percent excess weight loss at 1-year postoperative was 72.4%. There were no mortalities. Compared with the literature, we achieved a lower rate of anastomotic leak (0.3% vs. 2%, P = 0.001) and stomal stenosis (1% vs. 4.7%, P = 0.001). Conclusions: Excellent outcomes following laparoscopic gastric bypass can be achieved in a community hospital-based program with moderate case volume. Reimbursement decisions should take into consideration a program's actual outcomes rather than volume.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalAnnals of surgery
Volume252
Issue number1
DOIs
StatePublished - Jul 1 2010

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