Comparison of weight loss after gastric exclusion and partitioning
G. W. Lechner and D. W. Elliott
We report follow-up findings after two to almost four years on 100 patients
who were described in a previously published prospective randomized series.
Horizontally stapled gastric partition (gastroplasty) was compared with
gastric exclusion (bypass) using a Roux-en-Y jejunal loop. An additional
142 patients had the identical operative procedures performed during the
same time period, but chose their own operation. Both procedures used a
small gastric pouch (15 mL) and calibrated 10-mm opening. Weight loss was
better after exclusion and has continued to be better. Patients who lose
weight well do not regain. There were complications in 8% of the exclusion
patients and 12% of the partitioning patients and one death in the
exclusion group--0.4% of the total group. Since gastric exclusion is safe
and produces significantly better weight loss, we believe it sets the
current standard against which all other bariatric surgery must be
compared.
