Bariatric surgery evolution in Romania. Results during first year after a variety of bariatric procedures

Obesity is a worldwide public health problem (both in developed and developing countries), the most frequent nutritional disease in the world, with considerable morbidity-mortality and high costs for the public healthcare systems. Bariatric surgery has been found to be the only method capable of maintaining proper and long-lasting weight loss for morbid obesity. Laparoscopy is the gold standard for bariatric procedures. We studied a group of 341 patients who underwent different types of laparoscopic bariatric surgical procedures: laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), laparoscopic gastric bypass (LGB) and laparoscopic bilio-pancreatic diversion (LBPD). They were evaluated preoperative (weight, BMI, co-morbidities) and followed-up for 1 year: 238 patients LAGB, 46 LSG, 49 LGB and 8 LBPD. Mortality and conversion rate were nil for all groups. A significant reduction in patients' weight was shown at 12 months postoperatively. BMI decreased from 45.6 kg/m 2 to 37.9 for LAGB, from 54.12 to 40.8 kg/m 2 for LGB and from 49.1 to 31.2 kg/m 2 for LSG. The excess weight loss for LBPD was 63%. A significant improvement of co-morbidities was noticed; all patients with type 2 diabetes have normal serum glucose levels at 1 year after surgery. Bariatric surgery is safe with a low complication rate and the outcome was similar to literature data. Although we do not benefit of a long time follow-up, the favorable results allow us to state that minimally invasive surgical techniques deserve an important place in the efforts of struggling against obesity and its consequences.