Implementation of mini gastric bypass in the Netherlands: early and midterm results from a high-volume unit.

Abstract

Mini gastric bypass (MGB) is a promising and attractive alternative bariatric procedure. In 2011, we introduced MGB in our high-volume bariatric unit. Subsequently, we evaluated short- and midterm results of this procedure. A prospective cohort of patients who underwent MGB between 2012 and 2013 was retrospectively evaluated. From 2012 to 2013, primary MGB was performed in 287 patients with a mean BMI of 42kg/m2 (range 32-76kg/m2). The mean operation time was 50min (range 25-120min). The mortality rate was 0%. Serious complications, such as leakage, pulmonary embolism, or bleeding, occurred in 3.1% of patients; anastomotic leaks occurred in 1.4% of patients. Conversion to Roux-en-Y gastric bypass for biliary reflux or other indications occurred in six patients (2%). During our initial learning phase, biliary reflux rates were higher due to an overly short pouch. Surgical revision for malnutrition was performed in one patient. Percent excess weight loss and percent total body weight loss were 85 and 35%, respectively, after 1year; 88 and 36.6%, respectively, after 2years; and 83 and 34.3%, respectively, after 3years. Follow-up rates after 1, 2, and 3years were 96% (277/287), 72% (208/287), and 66% (190/287), respectively. As a primary bariatric procedure, MGB is associated with good early and midterm results. MGB has the potential to become a significant alternative bariatric procedure. Correct technique is of extreme importance when performing MGB; therefore, the appointment of an experienced MGB surgeon as a guide when beginning to utilize this technique is advised.