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Using this systematic approach, it has been possible to cover >99% of all bariatric surgery, cross-matching our data with nation-wide registries for in-hospital care, cause of death, and permitting regular nation-wide audit. Several scientific studies have used, or are using, what seems to be the most comprehensive database in obesity surgery.

The reaction between antiplasmin (A) and a low-molecular-weight form of plasmin (P) proceeds in at least two steps : a fast reversible second-order reaction followed by a slower irreversible first-order transition, and may be represented by: kk -1 The low-M, plasmin, which is obtained by limited elastase digestion, is composed of an intact B chain and a small A chain lacking the lysine-binding sites. The k , of the reaction is (6.5 & 0.5) x lo5 M -s-l which is 30 -60 times smaller than that for normal plasmin and antiplasmin. The dissociation constant of the first step is 1.9 x lop9 M which is 10 times higher than for normal plasmin and antiplasmin. The rate constant of the second step is (4.2f0.2) x s-l for both normal and low-M, plasmin. Low M , plasmin which has substrate bound to its active site does not react or reacts only very slowly with antiplasmin. The reaction rate, however, is only slightly influenced by 6-aminohexanoic acid in concentrations up to 1 mM which decrease the reaction rate of normal plasmin approximately 50-fold.The findings further indicate that the lysine-binding site(s) of plasmin are of great importance for the rate of its reaction with antiplasmin.

Intraoperative adverse events and conversion to open surgery are the strongest risk factors for serious complications after laparoscopic gastric bypass surgery. Annual operative volume and total institutional experience are important for the outcome. Patient related factors, in particular age, also increased the risk but to a lesser extent.

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