The impact of sleeve gastrectomy and gastric binding on weight loss and remission on comorbidities: a national registry-based study

Minerva Surg. 2022 Oct;77(5):455-467. doi: 10.23736/S2724-5691.21.09250-9. Epub 2022 Mar 1.


Background: In recent decades, an extensive collection of research has shown various benefits of bariatric surgery in the remission of obesity-related diseases and in weight loss in patients with obesity. This study investigated whether sleeve gastrectomy (SG) or adjustable gastric banding (AGB) has the best benefit in terms of perioperative risk, weight loss, and remission of comorbidities.

Methods: The German Bariatric Surgery Registry included 32,051 patients after SG and AGB. Outcome criteria were perioperative morbidity, perioperative complications, and remission of comorbidities after a one-year follow-up.

Results: Out of them 16,441 patients had completed one-year follow-up (2042 patients after AGB and 14,399 after SG). The %EWL was 40.8±23.4 for AGB and 62.4±22.6 for SG (P<0.001). BMI reduction was a significant difference in favor of SG (8.0±4.7 after AGB vs. 15.5±5.9 after SG; P<0.001). Significant differences in favor of SG were also found for remission of IDDM (P<0.001), NIDDM (P<0.001), hypertension (P<0.001), sleep apnea (P<0.001), and reflux disease (P<0.001). However, no significant difference was found between the two groups in terms of general intraoperative and general postoperative complications (P=0.809 and P=0.883, respectively). Specific postoperative complications were documented significantly more often after SG (3.4% in SG vs. 1% in AGB; P<0.001).

Conclusions: Based on the results of our study, we can conclude that both SG and AGB can be safe surgical procedures. However, SG achieved more significant results in terms of remission of comorbidities. AGB is effective in patients without severe comorbidities and high BMI.

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Gastrectomy / adverse effects
  • Gastroplasty* / adverse effects
  • Humans
  • Obesity / epidemiology
  • Obesity, Morbid* / epidemiology
  • Postoperative Complications / epidemiology
  • Registries
  • Weight Loss