Laparoscopic Roux-en-Y gastric bypass in adolescents with morbid obesity--surgical aspects and clinical outcome.

In this paper, we address surgical aspects on bariatric surgery in adolescents from a nationwide Swedish study. Laparoscopic gastric bypass surgery was performed for 81 adolescents with morbid obesity (13-18 years), while 81 adolescents with obesity-matched by age, sex, and BMI received conventional care. Another comparison group was adults undergoing gastric bypass at the same institution during the same time period. This report addresses the 2-year clinical outcome and five-year surgical adverse event rate. Body weight decreased from 133 kg (SD = 22) at inclusion to 92 kg (SD = 17) after 1 year and was 89 (SD = 18) after 2 years (p < 0·001) representing a 32% (-35 to -30) weight loss after 2 years, corresponding to 76% (-81 to -71) excess weight loss. Weight loss was similar in the adult gastric bypass patients (-31%) while weight gain (+3%) was seen in the conventionally treated obese adolescents. Significant improvement in cardiovascular and metabolic risk factors and inflammation was seen after surgery. The treatment was generally well tolerated and quality of life improved significantly. The surgical adverse events included cholecystectomies (10%) and operations for internal hernia (9%) but no postoperative mortality. Adolescents undergoing laparoscopic gastric bypass surgery achieve similar weight loss to adults. Improvements in risk factors and quality of life were substantial. There were surgical complications similar to the adult group, which may be preventable.