Gastric bypass surgery is riskiest for those who need it most

CHICAGO The same health risks that make morbidly obese patients eligible for gastric bypass surgery also leave them susceptible to complications during and after the surgery, a study of 335 patients shows.

The patients all had Roux-en-Y gastric bypass at the University Hospitals of Cleveland from 1998 to 2002. Roux-en-Y is the most popular surgery in the treatment of severely obese patients to help weight loss. It involves stapling the upper stomach to create a small pouch that is then attached to the small intestine, reducing the capacity of the stomach. Subsequent radiologic imaging helped to identify 57 complications from the surgeries many of them multiple problems in the same patients including suture tears and leaks, pulmonary embolism, pneumonia and infection.

"This should not be considered a cosmetic procedure," said Elmar Merkle, M.D., the lead author of the study, who presented the findings today at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA). "People need to be aware of the potential complications of this surgery. It basically should be the last option we can offer the morbidly obese, after other less invasive interventions such as diet and exercise have been tried."

The number of gastrointestinal surgeries for weight loss is soaring, according to the American Society for Bariatric Surgery, which estimates that the 63,000 procedures performed in 2002 will increase to 100,000 this year. Americans who are at least 100 pounds overweight are eligible for gastrointestinal surgery, according to National Institutes of Health (NIH) guidelines, but a patient who is less than 100 pounds overweight may also be considered if there is a life-threatening condition related to his or her obesity, such as type 2 diabetes or cardiopulmonary problems.

"Severely obese patients are considered to be at high risk for any type of surgery because of these co-morbidities," said Dr. Merkle, c

Contact: Maureen Morley
Radiological Society of North America

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