Postoperative EWL.

Preop EWL 6-month EWL 12-month EWL

0-10% 51.4% 63.2%10-20% 50.5% 64.6%�20% 56.7% 67.5%

PII: S1550-7289(08)00257-8

P84.

THE IMPACT OF LAPAROSCOPIC BARIATRICSURGERY ON COMPONENTS OF METABOLICSYNDROMEChunHong Bai; Clare Nugent; Hazem Elariny, MD;Mariam Afendy; Angela Wheeler; Arian Afendy;Michael Garone; Caitlin Quigley; Priya Gopalakrishnan;Aimal Arsalla; Oscar Chan, MD;Zobair M. Younossi, MD, MPH, FACP, FACG; TranslationalResearch Institute - Inova Health System, Falls Church, VA,USA.

Background: Metabolic syndrome (MS) and Non-Alcoholic FattyLiver Disease (NAFLD) are commonly found in morbidly obesepatients undergoing bariatric surgery. The aim of this study is toassess the impact of bariatric surgery on the resolution of MS andNAFLD.Methods: Two hundred and sixty three patients who underwentbariatric surgery and had at least one follow up were included inour study. Clinical and laboratory data were available.Results: Of this cohort, 27.0% underwent malabsorptive surgery,57.0% underwent restrictive surgery and 16.0% combination re-strictive-malabsorptive surgery. The majority (98.5%) of the sur-gical procedures were performed laproscopically. Mean weightloss after surgery was 33.7 � 20.1 kg after restrictive surgery(follow up period 298 � 271 days), 39.4 � 22.9 kg after malab-sorptive surgery (follow-up period 306 � 290 days) and 28.3 �14.1 kg after combination surgery (follow up period 281 � 239days). Regardless of the type of bariatric surgery, significant im-provements were noted in DM (p-values from �0.0001-0.0005),MS (p-values from �0.0001-0.01), waist circumference (p-values�0.0001), BMI (p-values �0.0001), fasting serum triglycerides(p-values �0.0001 to 0.001), and fasting serum glucose (p-values�0.0001). Additionally, a significant improvement in AST/ALTratio (p-value � 0.0002) was noted only in those with restrictivesurgery. Multivariate analysis showed that patients who underwenta malabsorptive bariatric procedure experienced a significantlygreater percent weight loss of excess body weight (PWLEBW)than patients who underwent a restrictive procedure (p-value �0.0451). PWLEBW increased with longer post-operative fol-low-up (p-value � 0.0001).Conclusion: Weight loss after bariatric surgery is associated witha significant improvement in MS and factors associated withNAFLD.

PII: S1550-7289(08)00258-X

P85.

THE IMPACT OF LONG-TERM SURGICAL FOLLOW-UP ON WEIGHT LOSS AFTER LAPAROSCOPIC ROUX-Y GASTRIC BYPASSAlain Ramirez, MD; Andrew J. Duffy, MD;Kurt E. Roberts, MD; Robert L. Bell, MD; Surgery, Yale Uni-versity, New Haven, CT, USA.

Background: Sustained weight loss after laparoscopic Roux-Ygastric bypass (LRYGB) depends on multiple factors includingcompliance with diet and behavior modifications. The importanceof long-term follow-up after LRYGB is well-recognized but littleis known about the relationship between patient appointment com-pliance and weight loss. We hypothesize that patients who weremost reliable in attending clinic appointments after LRYGB hadmore successful weight loss.Methods: Patients are provided postoperative visits at 2, 6, 12, 24,and 36-months. With IRB approval, patients who missed appoint-ments were contacted and informed consent obtained. All partic-ipants were queried according to a scripted questionnaire andvariables recorded included compliance with diet and exercise,weight, and the primary deterrent to clinic attendance. Weight lossis correlated with yearly visit compliance using Fisher’s exact test.Results: There were 283, 157, and 56 total patients at the one, two,and three-year intervals. Similar distributions of gender, ethnicity,and comorbidities were observed at all three time intervals regard-less of compliance. Excess weight loss (EWL) was not signifi-cantly different between patients who did and did not make theirone (63.2% vs 65.4%) and two year appointments (65.5% vs63.3%). By the third postoperative year, those who kept appoint-ments exhibited a 73.3% EWL compared to 51.2% in patients whomissed appointments (p�0.05).Conclusion: Follow-up appointments reinforce positive lifestylechanges while providing an opportunity for patients to seek sup-port. The value of these visits cannot be measured merely withEWL. Regardless of compliance with clinic visits, patients maythrive in the short term following LRYGB. However, our datashow that sustained weight loss correlates with patient compliancewith prescribed follow-up appointments.

PII: S1550-7289(08)00259-1

P86.

PROXIMAL VERSUS DISTAL REVISIONAL SURGERYFOR WEIGHT REGAIN FOLLOWING ROUX-EN-YGASTRIC BYPASSDaniel E. Swartz, MD; Elijah Mobley, MD;Edward L. Felix, MD; Advanced Bariatric Center, Fresno, CA,USA.

Background: While revisional operations for weight regain areincreasing, few studies compare outcomes of these secondaryprocedures. The aim of this study was to compare weight loss afterrevision of the pouch and gastrojejunostomy (proximal revision) toreduction of common channel length (distal revision).Methods: We retrospectively reviewed consecutive patients un-dergoing revisional surgery for weight regain following Roux-en-Y gastric bypass (RYGB). Patients with a dilated pouch orstoma were offered proximal or distal revision while those withnormal proximal anatomy were offered only distal revision. Mean

344 Abstracts: 2008 Poster Session 3 / Surgery for Obesity and Related Diseases 4 (2008) 312–357