Introduction:

Laparoscopic roux-en-y gastric bypass (LRYGB) has been performed at Landspitali University Hospital (LSH) since 2001. The procedure represents an important treatment option for morbidly obese patients. The aim of this study is to evaluate the long-term results of these operations in Iceland.

Material and methods:
All 772 consecutive patients undergoing LRYGB at LSH during 2001-2015 were included. Information was collected from a prospective database. Successful weight loss was defined as body mass index (BMI) less than 33 kg/m² or excess body mass index loss (EBMIL) more than 50%.

Results:
Mean age of patients was 41 years and 83% were females. Mean pre-operative weight was 127 kg (±20) and mean BMI was 44 (±6). Mean %EBMIL was 80% after 1.5 year, 70% after 5 years and 64% after 10-13 years. 85% of patients had successful weight loss with a mean follow-up time of 7.4 years. Pre-operatively patients on average had 2.8 obesity related comorbid diseases. 71% of patients with type 2 diabetes were in full remission after surgery. One third of patients with hypertension and one third of patients with hyperlipidemia achieved full remission after surgery. 37 patients (5%) had an early complication and 174 (25%) had a late complication that frequently needed surgical solution.  Most patients  (78%) needed repeated adjustment of vitamins and minerals often many years after surgery.

Conclusion:
Majority of patients achieved a successful weight loss and most obesity related comorbidities are still in remission 7.4 years after surgery. Early complications were rare but one fourth of patients had late complications. Life long follow-up is of utmost importance after gastric bypass surgery.

Table I, Table II, Table III, Table IV, Table V, Table VI, Table VII

Figure 1, Figure 2, Figure 3a, Figure 3b

Rósamunda Þórarinsdóttir¹, Vilhjálmur Pálmason¹, Björn Geir Leifsson², Hjörtur Gíslason²

¹Department of Medicine, University of Iceland, ²Surgical department Landspitali University Hospital.