Gastric surgery for morbid obesity. Complications and long-term weight control.

The efficacy of gastric surgery for morbid obesity has often been questioned because of incomplete long-term patient follow-up. Between 1977 and 1984, 537 consecutive patients received either a gastric bypass with a Roux-en-Y gastrojejunostomy, an unbanded gastrogastrostomy, or a vertical banded gastroplasty. The follow-up period was 5 years for all patients who underwent Roux-en-Y gastrojejunostomy and unbanded gastrogastrostomy and 3 years for all patients who underwent vertical banded gastroplasty. Only 5.8% of all patients were unavailable for this late follow-up. The unbanded gastrogastrostomy was not an effective weight-control operation. Both the Roux-en-Y gastrojejunostomy and vertical banded gastroplasty provided effective long-term weight control. Although the Roux-en-Y gastrojejunostomy gave slightly better weight control than the vertical banded gastroplasty, the more simple, safe, and physiological vertical banded gastroplasty is the procedure of choice for most patients with morbid obesity.