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• W2094230936 abstract "Bien que le bypass gastrique laparoscopique (BPL) soit considéré comme le geste de référence en chirurgie bariatrique, beaucoup de chirurgiens bariatriques français ne l’ont pas encore réalisé, alors qu’il est réputé difficile et nécessite une longue courbe d’apprentissage. Le but de ce travail était de rapporter les résultats des 50 premiers BPL effectués par un opérateur exerçant seul la chirurgie bariatrique dans un centre hospitalier général français. Entre avril 2007 et février 2009 les 50 premiers BPL ont été analysés. Les suites opératoires et la courbe d’apprentissage ont été évaluées prospectivement par la durée opératoire (DO), la durée moyenne de séjour (DMS), le taux de complications précoces et tardives, la réduction des comorbidités ainsi que par le pourcentage de perte d’excès de poids (PEP). L’âge moyen des patients était de 41,8 ± 9,8 ans, l’indice de masse corporelle (IMC), de 47,7 ± 7,1 kg/m2. La DO moyenne était de 146 ± 51 minutes. La DMS était de 5,3 ± 1,4 jours. Il y a eu trois conversions (6 %). Le taux de complications précoces et tardives était, respectivement, de 4 et 6 %. Le suivi moyen était de 6,3 ± 1,3 mois. Le pourcentage de PEP à trois, six, neuf et 12 mois était, respectivement, de 39,5 ± 9,0 %, 50,3 ± 10,9 %, 61,9 ± 9,7 % et 63,0 ± 10,5 %. À la condition de suivre une formation spécifique au BPL et de sélectionner ses premiers patients, le BPL est une technique réalisable sans morbimortalité majeure. Among the various bariatric procedures, laparoscopic Roux-en-Y gastric bypass (LRYGBP) is widely considered to be the gold standard. However, a majority of bariatric surgeons in France do not perform LFYGBP, perhaps because of its reputation as a technically demanding procedure with a long learning curve. This study evaluates the outcomes and the learning curve for the first 50 LFYGBP performed by one surgeon in a French non-university hospital. Between April 2007 and February 2009, we performed our first 50 cases of LRYGBP. Surgical outcomes and the learning curve were measured by prospective criteria including length of stay, operative time, complications, percentage weight loss and reduction of obesity-related co-morbidities. The mean patient age was 41.8 ± 9.8 years. The mean BMI was 47.7 ± 7.1 kg/m2. The mean operative time was 146 ± 51 minutes and the mean hospital stay was 5.3 ± 1.4 days. Three cases (6%) were converted to open surgery. Early complications occurred in 4% and late complications occurred in 6%. The average follow-up was 6.3 ± 1.3 months. Overall excess weight loss was 39.5, 50, 62, and 63% at 3, 6, 9, and 12 months. LRYGBP can be performed with acceptable morbidity and short-term results, even during the early phase of a surgeon's learning curve. It is a feasible procedure for bariatric surgeons with previous experience in gastric banding." @default.
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• W2094230936 date "2009-08-01" @default.
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• W2094230936 title "Le bypass gastrique laparoscopique est-il dangereux durant la courbe d’apprentissage ? Étude prospective de 50 cas initiaux" @default.
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• W2094230936 doi "https://doi.org/10.1016/j.jchir.2009.08.020" @default.
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