Losing Weight Prior to Gastric Surgery Results in Fewer Complications

Weight loss undertaken before open or laparoscopic gastric bypass surgery is associated with fewer complications after the procedure, according to the results of a new study.

Researchers from Saint Francis Medical Center (Trenton, NJ, USA) reviewed records of 881 patients undergoing open or laparoscopic gastric bypass surgery at an obesity treatment center serving central Pennsylvania (USA), between May 2002 and February 2006. Prior to surgery, all patients underwent a 6-month multidisciplinary program with the goal of achieving a 10 percent weight loss. The primary endpoints of the study were loss of excess body weight and rates of total and major complications. In all, 592 (67.2%) of the 881 patients achieved a weight loss of 5 percent or more excess body weight, and a loss of more than 10 percent excess body weight was achieved by 423 patients (48%).

The results showed that increased preoperative weight loss was associated with decreased rates of total complications and decreased rates of major complications, based on univariate analysis. In a multiple logistic regression model controlling for age, sex, baseline body mass index, and type of surgery, increased preoperative weight loss predicted reduced rates of total complications and major complications. The study also found that compared to patients undergoing laparoscopic gastric bypass surgery, those referred for open gastric bypass were generally older, had a higher body mass index (BMI), and were more often male. In addition, they had higher total complication rates and major complication rates compared to patients undergoing laparoscopic gastric bypass surgery. The study was published in the December 2009 issue of Archives of Surgery.

"Preoperative weight loss is associated with fewer complications after gastric bypass surgery,” concluded lead author Peter Benotti, M.D., and colleagues. "We hope that these findings will be confirmed by prospective, controlled trials and that bariatric surgeons will consider this modality for preoperative risk reduction in selected patients who are deemed high risk for complications after surgery.”

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