Laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding in the super-obese: peri-operative and early outcomes

Scand J Surg. 2015 Mar;104(1):5-9. doi: 10.1177/1457496914553148. Epub 2015 Jan 26.

Abstract

Introduction: Controversy exists between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding in super-obese patients.

Methods: This is a retrospective review of prospectively collected data. A total of 102 consecutive super-obese (body mass index >50) patients underwent laparoscopic Roux-en-Y gastric bypass (Group 1), and 79 consecutive ones underwent laparoscopic adjustable gastric banding (Group 2). Early complications and weight loss outcomes were evaluated.

Results: No significant difference was found in operative mean (± standard deviation) time (93.5 ± 33 vs 87.7 ± 39 min, p = 0.29), hospital stay (2.68 ± 2.27 vs 2.75 ± 1.84 days, p = 0.80), or overall early postoperative morbidity (17.65% and 10.12%, p = 0.20). Intra-operative complications occurred in six patients (5.9%) in Group 1 and none in Group 2 (0.0%, p = 0.04). Mean excess weight loss percent at 6 and 12 months in Group 1 was 44.75% ± 11.84% and 54.71% ± 18.18% versus 26.20% ± 12.42% and 31.55% ± 19.79% in Group 2 (p < 0.001).

Conclusion: There seems to be no significant differences in early complications between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding operations in the short term. Weight loss and excess weight loss percent at 6 and 12 months are significantly better after laparoscopic Roux-en-Y gastric bypass.

Keywords: Morbid obesity; bariatric surgery; body mass index >50; gastric bypass; laparoscopic adjustable gastric banding; laparoscopy; super-obese; super-obesity; weight loss.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Female
  • Gastric Bypass* / adverse effects
  • Gastroplasty* / adverse effects
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss