• Craig See, Preston L Carter, David Elliott, Philip Mullenix, William Eggebroten, Clifford Porter, and David Watts.
• General Surgery Service, Madigan Army Medical Center, Tacoma, WA 98431-5000, USA.
• Am. J. Surg. 2002 May 1;183(5):533-8.

BackgroundComplication rates for laparoscopic bariatric surgery remain in evolution.MethodsSingle institution review of the initial year's experience with laparoscopic gastric bypass compared with open gastric bypass complications for the same period.ResultsThere were 20 laparoscopic and 52 open gastric bypass procedures. Five laparoscopic patients had major complications. There were 4 anastomotic leaks. Nine open bypass patients had major complications, with 2 leaks. Leak rate was 20% for the laparoscopic group and 4% for the open group. All leaks in both groups led to substantial morbidity. There were two deaths, one in each group. The laparoscopic death was from postleak sepsis.ConclusionsGastric bypass, whether done open or laparoscopically, has significant surgical risk. Complication profiles differed between the two groups. Anastomotic leaks were significantly more frequent in the laparoscopic group, probably related to the learning curve. There is a continued need for open surgery in many bariatric patients.

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