Roux-en-Y gastric bypass vs gastric banding for morbid obesity: a case-matched study of 442 patients

Arch Surg. 2012 May;147(5):460-6. doi: 10.1001/archsurg.2011.1708.


Hypothesis: Gastric banding (GB) and Roux-en-Y gastric bypass (RYGBP) are used in the treatment of morbidly obese patients. We hypothesized that RYGBP provides superior results.

Design: Matched-pair study in patients with a body mass index (BMI) less than 50.

Setting: University hospital and regional community hospital with a common bariatric surgeon.

Patients: Four hundred forty-two patients were matched according to sex, age, and BMI.

Interventions: Laparoscopic GB or RYGBP.

Main outcome measures: Operative morbidity, weight loss, residual BMI, quality of life, food tolerance, lipid profile, and long-term morbidity.

Results: Follow-up was 92.3% at the end of the study period (6 years postoperatively). Early morbidity was higher after RYGBP than after GB (17.2% vs 5.4%; P<.001), but major morbidity was similar. Weight loss was quicker, maximal weight loss was greater, and weight loss remained significantly better after RYGBP until the sixth postoperative year. At 6 years, there were more failures (BMI>35 or reversal of the procedure/conversion) after GB (48.3% vs 12.3%; P<.001). There were more long-term complications (41.6% vs 19%; P.001) and more reoperations (26.7% vs 12.7%; P<.001) after GB. Comorbidities improved more after RYGBP.

Conclusions: Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than GB, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after GB.

Publication types

  • Comparative Study

MeSH terms

  • Gastric Bypass*
  • Gastroplasty*
  • Humans
  • Obesity, Morbid / surgery*