The Mini-Gastric bypass in Italy. Outcome from 974 consecutive laparoscopic procedures in a multicentre study.

Introduction: Because of the failure of the “Old Mason Loop” the Mini-Gastric Bypass (MGB) has been viewed with skepticism. Over the past 16 years a growing number of authors from around the world have continued to report excellent short and long term results with the MGB. Materials and Methods: One university centre, three regional and two private hospitals participated in this study. From July 2006 to December 2012, 475 male and 499 female patients (pts) (48.8% vs. 51.2%), underwent 974 laparoscopic MGB. Mean age was 39.4, preoperative body mass index (BMI) was 48±4.58 kg/m2. Type 2 diabetes (T2DM) affected 224/974 pts. Major endpoints were to define both MGB safety and efficacy in the long term. Results: Conversion rate to open was 1.2% (12/974), mortality was 2/974 patients (0.2%). Pre-operative morbidity was 54/974 (5.5%), and mean hospital stay (LOS) was 4.0±1.7 days. Late complications affected 73/974 pts (7.4%). The majority 66/74 (89.1%) occurred within one year. Bile reflux gastritis was symptomatic with endoscopic findings in 8/974 patients (0.8%), acid peptic ulcers were reported in 14/974 (1.4%). At 60 months the EWL% was 77 ± 5.1, T2DM remission 84.4% and resolution of hypertension 87.5%. Conclusions: Other bariatric procedures have been recognized to have major limitations. In spite of initial skepticism, this study, along with many other large scale, long term similar studies from around the world (Taiwan, USA, France, Spain, India, Lebanon and others) demonstrates the MGB to be a short, simple, low risk, effective and durable bariatric procedure.