Background

Roux-en-Y gastric bypass (RYGB) is a well-established metabolic surgical procedure; however, long-term follow-up data is limited. The purpose of this study is to report long-term (>15 year) outcomes following RYGB.

Methods

A retrospective review of RYGB performed at a single COE from 2001-2008 was conducted. Primary outcomes were mean percent body weight loss (using repeated measures regression), percent with diabetes (compared between insulin and non-insulin using chi-square test), and Kaplan-Meier estimated death rates (compared by age and diabetes using Logrank tests).

Results

During the analysis period, there were 2045 patients that underwent RYGB. 10+ year follow-up was available for 68% of the patients (n=1388) and 48% had >15 years of follow-up (n=987). Preoperative mean age was 46 (18-72) and BMI (kg/m2) 47.9 (35-82.2). Maximum mean post-RYGB weight loss of 31.8% occurred at 18 months post-operatively. Mean weight loss stabilized at 23% at 10-20 years post-RYGB. Of the 677 patients with pre-operative diabetes, 10% were insulin-dependent post-RYGB diabetes remission rates were 54% at 3 years but decreased to 38% at 15 years. The rate of persistent diabetes post-RYGB was higher in pre-operative insulin-treated diabetes (p<0.0001). The overall 15-year death rate following RYGB was 13.3%, but was 37.4% in diabetics patients > 60 years. Time until death was shorter for older age (p<0.0010) and patients with pre-operative diabetes (p<0.0001).

Conclusions

Our study represents one of the largest studies of long-term follow data for patients undergoing RYGB. Our data demonstrates that RYGB is successful in sustained weight loss and diabetes remission.