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    Weighing the Risks of Gastric Bypass Surgery continued...

    This procedure can be done by making a large incision in the abdomen or by making several small incisions and using small instruments and a camera to guide the surgery, which is known as laparoscopic surgery.

    The popularity of gastric bypass surgery in the U.S. for the treatment of obesity has surged in recent years with a more than 10-fold increase in the number of procedures performed in 2001 compared with 1987. This increase has been attributed to both the rise in obesity rates and the availability of less invasive laparoscopic techniques.

    In fact, Flum's study showed the number of gastric bypass surgeries performed among the patients studied increased by 250% after laparoscopic gastric bypass surgery was introduced in 1997.

    Although the procedure has become increasingly common, Flum says his study is the first to look at the effect of gastric bypass surgery on the risk of death in the "real world" among a large number of people who had the procedure performed by a variety of surgeons. The results appear in the November issue of the Journal of the American College of Surgeons.

    The study compared the number of deaths following gastric bypass surgery in more than 3,300 obese people who had the procedure from 1987 to 2001 with those reported among a group of more than 60,000 similarly matched obese people who did not have the procedure.

    Researchers found the short-term risk of death following gastric bypass surgery was much higher than previously thought, specifically:

    • 1.9% of gastric bypass surgery patients died within 30 days after the procedure, which is four times higher than the rate of about 0.5% suggested by smaller previous studies.
    • Nearly half of all early deaths occurred after the patient came home from the hospital.
    • The risk of death within 30 days after gastric bypass surgery was nearly five times higher if the surgeon had performed less than 20 of the procedures than if the surgeon had more experience.
    • Of the cases in which the patient died within 30 days after gastric bypass surgery, 81% were among the surgeons first 19 gastric bypass surgeries.

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