Pediatric Gastric Bypass: Is it Time to Rethink? Lessons Learned from a Single Institution Experience

Pediatric obesity is a growing problem in United States. Ideally, a non-operative option is preferred but currently there is no medical treatment that guarantees an enduring weight loss. Laparoscopic adjustable gastric banding is popular in some centers due to its safety profiles. Due to the limited experience, gastric bypass, which has shown excellent outcomes in adult population, is less popular in the pediatric population. Aims: To evaluate our initial experience with gastric bypass in adolescent population. Patients and methods: Between January 2008 and July 2010, 19 adolescents with morbid obesity underwent laparoscopic Roux Y gastric bypass with a Roux limb of 140 cm. Results: Mean age 18 years (range: 16-20 years), Male: female ratio= 1:18, Mean weight=305 Ib (range= 230-384), Mean BMI=50 (range: 42-67). Mean Percentage excess weight loss was 88% and 74% at 1 and 2 years respectively. No patient was lost to follow- up. There was a near complete resolution of almost all associated co-morbidities. Four complications occurred during the study period (1internal hernia, I surgical site infection, 1 hypoglycemic episode and 1 stomal stenosis). Of these, only one patient required reoperation. Conclusion: Although our initial experience is limited by the small sample size, we believe that our results are comparable to those reported in adult population. We believe that gastric bypass is a viable option alternative in the adolescent population.