Preoperative Weight Loss Before Bariatric Surgery

Hypothesis: Preoperative weight loss reduces the frequency of surgical complications in patients undergoing bariatric surgery. Design: Review of records of patients undergoing open or laparoscopic gastric bypass. Setting: A comprehensive, Multidisciplinary obesity treatment center at a tertiary referral center that serves central Pennsylvania. Patients: A total of 881 patients undergoing open or laparoscopic gastric bypass from May 31, 2002, through February 24, 2006. Intervention: All preoperative patients completed a 6-month multidisciplinary program that encouraged a 10% preoperative weight loss. Main Outcome Measures: Loss of excess body weight (EBW) and total and major complication Results: Of the 881 patients, 592 (67.2%) lost 5% or more EBW and 423 (48.0%) lost more than 10% EBW. Patients referred for open gastric body mass (n=466) were generally older (P <.001), had a higher body mass index (P <.001), and were more often men (P <.00 1) than those undergoing laparoscopic gastric bypass (n = 415). Total and major complication rates were higher in patients undergoing open gastric bypass (P<.001 and P=.03, respectively). Univariate analysis revealed that increasing preoperative weight loss is associated vAth reduced complication frequencies for the entire group for total complications (P=.004) and most likely for major complications (P =.06). Controlling for age, sex, baseline body mass index, and type of surgery in a multiple logistic regression model, increased preoperative weight loss was a predictor of reduced complications for an), (P=.004) and major (P =.03) complications. Conclusion: Preoperative weight loss is associated With fewer complications after gastric bypass surgery.