Gastric Bypass Surgery in the United States, 1998–2002

University of Louisville, Louisville, Ky, USA.
American Journal of Public Health (Impact Factor: 4.55). 07/2006; 96(7):1187-9. DOI: 10.2105/AJPH.2004.060129
Source: PubMed


We assessed the prevalence of gastric bypass surgeries in the United States on the basis of data from the 1998 to 2002 National Hospital Discharge Survey. Between 1998 and 2002, rates (per 100,000 adults) increased significantly (P<.001): from 7.0 to 38.6. This observed increase in the rate of gastric bypass surgery for the treatment of obesity may be attributed in part to improvements in surgical technique, improved patient outcomes, and increased popularity of this procedure.

Download full-text


Available from: Peter Eric Hilsenrath, Feb 04, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: With the worldwide epidemic of obesity, there has been an increase in the numbers of procedures of bariatric surgery such as the Roux-en-Y gastric bypass. Nevertheless, this type of surgery is not exempt from complications such as those described as "candy cane" Roux syndrome. We present the case of a 34-year-old female with previous diagnosis of morbid obesity (BMI 38.5 kg/m(2)) who underwent laparoscopic Roux-en-Y gastric bypass 2 years previously. Six months ago the patient presented intermittent epigastric pain of moderate intensity radiating towards the left hypochondrium. The patient reported no limitations of activities of daily living. Pain was associated with ingestion of carbonated beverages and ventral decubitus position. Upper gastrointestinal (GI) series was done, observing a blind, dilated jejunal loop adjacent to the gastrojejunal anastomosis. Suspicion of "candy cane" Roux syndrome was established. Exploratory laparoscopy and resection of the blind jejunal loop with stapler was done. Nine months later the patient is asymptomatic. Symptoms of these patients are nonspecific, and a high level of suspicion is required. The best study to evaluate this clinical entity is the upper GI series. The recommendation for bariatric surgeons is to minimize the length of the blind loop in the gastrojejunal anastomosis and to place it towards the right side to favor its drainage by gravity and eliminate problems in the jejuno-jejuno anastomosis that cause a retrograde expansion of the Roux-en-Y limb. Therefore, laparoscopic resection is the best method for the treatment of this syndrome.
    Full-text · Article · Jul 2010 · Cirugia y cirujanos
  • Source

    Full-text · Article ·
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bariatric surgery is the most effective treatment for achieving sustained weight loss in morbidly obese patients. Although the use of gastric bypass is growing rapidly, the potential life expectancy benefits of the procedure are unknown. We created a Markov decision analysis model to examine the effect of gastric bypass surgery on life expectancy in morbidly obese patients (body mass index [BMI] = 40 kg/m2). Input assumptions for the model were obtained from published life tables (baseline mortality risks), epidemiologic studies (obesity-related excess mortality), and large case series (surgical outcomes). In our baseline analysis, a 40-year-old woman (BMI = 40 kg/m2) would gain 2.6 years of life expectancy by undergoing gastric bypass (38.7 years versus 36.2 years without surgery). In sensitivity analysis, life-years gained with surgery remained substantial when assumptions were varied across reasonable ranges for surgical mortality risk (1.0-3.0 years) and effectiveness (0.9-4.4 years). Life-years gained with gastric bypass surgery did not vary considerably by age and sex subgroups. Relative to other major surgical procedures, gastric bypass for morbid obesity is associated with substantial gains in life expectancy. Long- term data from prospective studies are needed to confirm this finding.
    No preview · Article · Jan 2007 · Surgical Innovation
Show more