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Laparoscopic Gastric Bypass Versus Laparoscopic Banding

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Laparoscopic Gastric Bypass Versus Laparoscopic Adjustable Gastric Banding: A Comparative Study Of 1,200 Cases

Indications for and results of laparoscopic adjustable gastric banding (LAGB) and laparoscopic gastric bypass (LGB) are still controversial, especially between Europe and the United States. The recent availability of gastric bandings in the United States made it necessary to compare the two techniques.

Method

We compared a series of 456 laparoscopic gastric bypass to a series of 805 laparoscopic adjustable gastric banding performed in two different institutions. Body mass index (BMI), complication rate, mortality, and excess weight loss (EWL) after 3, 6, 12, and 18 months were obtained. A Fischer's exact test and a Student t test with covariance analysis were used for statistical analysis.

Results

Results are expressed as a mean +/- standard deviation, comparing laparoscopic gastric bypass with laparoscopic adjustable gastric banding. Preoperative BMI was 49.4 +/- 8.3 kg/m(2) versus 42.2 +/- 4.9 kg/m(2), respectively. Perioperative major complication rates were 2.0% versus 1.3% (NS), and the early postoperative major complication rates were 4.2% versus 1.7%, respectively. Mortality rate was 0.4% versus 0% (NS), respectively. The global EWL was 36.3% for laparoscopic gastric bypass versus 14.7% for laparoscopic adjustable gastric banding at 3 months , 51.6% versus 21.9% at 6 months, 67.0% versus 33.3% at 12 months, and 74.6% versus 40.4% at 18 months, respectively. Longterm followup for the laparoscopic adjustable gastric bandinggroup showed an EWL of 47% at 2 years, 56% at 3 years, and 58% at 4 years.Patients were sorted after their preoperative BMI. The EWL at 3, 6, 12, and 18 months was statistically superior in the laparoscopic gastric bypass group, for any BMI ranges.

Conclusion

These data suggest that laparoscopic gastric bypass provides a higher EWL at 18 months, compared with laparoscopic adjustable gastric banding, and this was true for any preoperative BMI range. It is associated with a higher early postoperative complication rate.

Source:
Biertho L, Steffen R, Ricklin T, Horber FF, Pomp A, Inabnet WB, Herron D, Gagner M. The Mount Sinai School of Medicine, Department of Surgery, Division of Minimally Invasive Surgery, New York, NY, USA.

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources