Laparoscopic Roux-en-Y gastric bypass vs. laparoscopic sleeve gastrectomy for morbid obesity and diabetes mellitus: a meta-analysis of sixteen recent studies

Hepatogastroenterology. 2013 Jan-Feb;60(121):132-7. doi: 10.5754/hge12510.


Background/aims: Bariatric surgery has become the best option for the treatment for morbid obesity. It is not only a weight-reducing surgery but also a metabolic surgery. This study examined the short-term results undergoing LRYGB and LSG of bariatric surgery.

Methodology: Studies and relevant literatures regarding the formation of LRYGB vs. LSG for morbid obesity or diabetes were searched through PubMed and Embase. The resolution of diabetes mellitus, resolution of hypertension and excess weight loss (EWL) in 12 months by LRYGB or LSG were pooled and compared using a meta-analysis. The odd ratios and mean differences were calculated with 95% confidence intervals to evaluate the influence of LRYGB.

Results: Sixteen recent studies including 2758 patients in total were included in this meta-analysis. These studies demonstrated that compared with LSG, LRYGB had the better effect in resolving diabetes mellitus and excess weight loss at 12 months, had a similar effect in resolving hypertension (pooled OR of 2.46 (95% CI: 1.48-4.09, p<0.00001), pooled OR of 0.81 (95% CI: 0.57-1.16, p>0.005), pooled mean difference of 8.27 (95% CI: 6.89-9.66, p<0.00001), respectively).

Conclusions: In bariatric surgery, LRYGB is a more effective and reliable treatment for morbid obesity and for surgical treatment of poorly controlled T2DM. More large, prospective, controlled, randomized trials should be conducted to further compare the efficacy and safety of this approach.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Diabetes Mellitus / surgery*
  • Gastrectomy / methods*
  • Gastric Bypass / methods*
  • Humans
  • Laparoscopy / methods*
  • Obesity, Morbid / surgery*
  • Publication Bias
  • Weight Loss