Studies Weigh Risks of Gastric Bypass Surgery
Long-Term Benefits of Gastric Bypass Surgery Seem to Outweigh Short-term Risks
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Weighing the Risks of Gastric Bypass Surgery continued...
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.
Long-Term Benefits of Gastric Bypass Surgery Pay Off
However, the study also showed that obese people who had gastric bypass surgery had a much lower risk of death over the long-term. After 15 years of follow up, 16% of obese people who did not have gastric bypass surgery died compared with 12% of those who did.
The long-term benefits of gastric bypass surgery in reducing the risk of death were greatest among young patients who were under 40 and the morbidly obese. After more than 13 years of follow up, only 3% of those who had the procedure died compared with 14% of morbidly obese people who did not have the procedure.
"The bottom line is that bariatric surgery, specifically gastric bypass, is a complicated operation in a complicated group of people," Flum tells WebMD. "When it's effective, it's very effective, but it has some real risks."
The second study, which appears in the September issue of the Annals of Surgery, also showed that gastric bypass surgery significantly reduced the risk of death over the long-term among morbidly obese people.
Canadian researchers followed more than 5,000 morbidly obese people who did not have surgery and compared them with nearly 1,000 morbidly obese people who had a gastric bypass between 1996 and 2002.
After five years of follow up, the study showed that 0.68% of those who had gastric bypass surgery died compared with 6% of the others, which translates to an 89% reduction in the risk of death.
The study also showed that people who had gastric bypass surgery had lower risks of developing heart disease, cancer, diabetes, and mental disorders compared with those who didn't.