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Studies Weigh Risks of Gastric Bypass Surgery

Long-Term Benefits of Gastric Bypass Surgery Seem to Outweigh Short-term Risks

WebMD Health News

Oct. 7, 2004 -- The immediate risks associated with gastric bypass surgery to treat obesity may be much higher than previously thought. But the long-term benefits of gastric bypass surgery in preventing death will likely outweigh those risks, according to new research.

Two new studies highlight the risks and benefits of increasingly popular bariatic or obesity-related surgeries, such as gastric bypass surgery, to treat people who are at extremely obese or morbidly obese in medical terms.

The first study shows that the risk of death within 30 days after gastric bypass surgery is at least four times higher than previously reported, and much of that risk was attributable to the surgeon's inexperience.

"It turns out that the 1 in 500 or 1 in 200 risk of death that people are commonly quoted comes from the best surgeons," says researcher David R. Flum, MD, MPH, assistant professor of surgery at the University of Washington. "In fact, in the real world ...the risk of dying within 30 days of surgery is about one in 50."

But Flum's study also showed that the long-term risk of death was much lower among those who had gastric bypass surgery compared with obese persons who did not.

Those long-term benefits in reducing the risk of death were echoed by the second study, which showed that morbidly obese people who had gastric bypass surgery had an 89% lower risk of death in the next five years compared with morbidly obese people who did not.

Experts say the studies show that gastric bypass surgery is not without risks, but those risks may be worth it over the long run.

"It's clear that bariatric surgery is the most effective therapy we have for people who have extreme obesity," says Samuel Klein, MD, council member of the North American Association for the Study of Obesity." It is also most costly in financial costs and mortality, but the benefits clearly outweigh the risks for properly selected patients."

Weighing the Risks of Gastric Bypass Surgery

During a gastric bypass surgery, surgeons create a small pouch in the stomach with staples or a plastic band, which dramatically reduces the amount of food a person can eat. In addition, a portion of the small intestine is attached to the pouch to allow the food to bypass the rest of the stomach and the upper portion of the small intestine in order to reduce calorie and nutrient absorption.

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.

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