الفهرس 
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Abstract
Roux-en-Y gastric bypass (RYGB) is currently considered the gold standard surgical option for the treatment of morbid obesity. We performed this study is to evaluate the effectiveness of Roux-en-Y gastric bypass operation in the management of morbid obesity, study the complications that may result from the operation and monitor the changes in the complete blood count, blood glucose level, lipid profile, serum calcium, 25-hydroxyvitamin D and parathyroid hormone levels after surgery.
Methods: Thirty patients with clinically morbid obesity were included in our study, all of them underwent Open Roux-en-Y Gastric Bypass operation during the period between January 2009 and February 2012 with at least one year follow up period after surgery. The reported outcome included surgical results, weight loss and improved status of co-morbidities, in addition to monitoring the laboratory changes in the studied issues.
Results: the mean preoperative blood loss was (298.4 cc). The mean operation time was (175 min). The mean length of postoperative hospital was (7.1 days). The incidence of intraoperative complication was 6.6% and included one case (3.3 %) of splenic injury and one case (3.3 %) of liver injury. Early postoperative complications included; postoperative chest infection in two patients (6.6%), wound infection in two patients (6.6%) and partial wound dehiscence in two patients (6.6%). Late complications included; gallstones in one patient from 27 (3.7%), Stomal stenosis in one patient (3.3%) and incisional hernia in two patients (6.6%). One year after surgery: the mean BMI decreased significantly from 48.38 ± 7.82 kg/m2 preoperatively to 31.42 ± 6.93 kg/m2 (p-value < 0.001) with a mean reduction in BMI of 16.96 kg/m2.The mean percentage of excess body weight loss was 60.6±1.5%. The mean WBCs count decreased significantly, while the mean HB concentration and platelets count decreased non-significantly. The mean fasting plasma glucose level decreased significantly among diabetic patients. The mean parameters of the entire lipid profile were found to have a statistical significant improvement. The mean serum calcium level decreased non-significantly, while the mean serum PTH, and 25 OH – vitamin D increased non-significantly. Comorbidities showed significant reduction in the prevalence of dyslipidemia and psychological upset, while, other preoperative co-morbidities related to morbid obesity decreased non-significantly.
Conclusions: Roux-en-Y gastric bypass operation is an effective and efficient operation not only in reduction of body weight but also in amelioration or even cure of obesity related comorbidities. The complication of the operation is reasonable and accepted as compared to its benefits in decreasing body weight, reducing or even curing obesity related comorbidities and improving quality of life. RYGB has an excellent and effective role in reducing blood glucose level and even curing some diabetic patients, controlling and even curing hypertension in some hypertensive patients and improving lipid profile in patients with Hyperlipidemias. Post operative.