Late Outcome of Isolated Gastric Bypass
Bibliographic record
Abstract
OBJECTIVE: To complete a long-term (>5 years) follow-up of patients undergoing isolated gastric bypass for severe obesity. SUMMARY BACKGROUND DATA: Previous experience as well as randomized trials suggested that the ideal operation for obesity should rely on manipulation of satiety rather than the production of malabsorption. Such an operation should incorporate a small gastric pouch of less than 30 mL placed in a dependent position on the lesser curvature of the stomach, not dependent on staples, and separated from the remaining stomach with a retrocolic, retrogastric Roux-en-Y gastrojejunostomy without external support. METHODS: The authors established an obesity clinic where patients were seen six times during the first year and semiannually thereafter. Emphasis was placed on defining success in terms of approximation to normal body-mass index. RESULTS: Of 274 patients, 243 (89%) were followed up for 5.5 +/- 1.5 years. Before surgery, the patients were obese (n = 13), morbidly obese (n = 134), or super-obese (n = 96). The obese and morbidly obese group achieved an excellent result, and the super-obese a good result. Individual results showed considerable variation from the mean. CONCLUSIONS: This study of isolated gastric bypass with a 5.5-year follow-up rate of 88.6% revealed a success rate of 93% in obese or morbidly obese patients and 57% in super-obese patients. Isolated gastric bypass compares favorably with biliopancreatic diversion in terms of weight loss, maximum weight loss, weight regain, current body-mass index, and percentage of patients with a body-mass index less than 35 kg/m2.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".