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Comparison of Laparoscopic versus Open Gastric Bypass Surgeries

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Laparoscopic versus Open Gastric Bypass: Comparison of Results

Laparoscopic gastric bypass (LGBP) is being performed widely as a treatment of choice for morbid obesity. Advantages over open gastric bypass (OGBP) have not been well documented in controlled studies. The aim of this study is to evaluate the early postoperative outcomes after laparoscope-assisted gastric bypass and open gastric bypass using a matched paired analysis.

Method

80 consecutive Laparoscopic gastric bypass patients were matched by age, gender, preoperative BMI, and number of co-morbid medical conditions to 80 open gastric bypass patients. Outcomes included length of stay (LOS), complications, percent excess weight lost (%EWL) and change in BMI over 1 year, time to return to normal activities, and quality of life (QOL). Continuous variables were analyzed using Wilcoxon Signed Ranks and discrete data were analyzed with McNemar tests.

Results

Baseline variables were matched (Laparoscopic gastric bypass/OGBP); age 43/42, mean preoperative BMI 44/46, co-morbid conditions 2.5/2.8. LOS was significantly shorter in the LGBP vs. open gastric bypass group (3.6 vs. 4.3 days). There was a trend to more major complications (internal hernias requiring reoperation) in the LGBP group that did not reach significance. Minor complications were comparable. %EWL was significantly better in the Laparoscopic gastric bypass group at 3, 6, and 9 months, but was comparable to the OGBP group at 1 year (Laparoscopic gastric bypass/open gastric bypass, 69%/65%). BMI at 1 year was also similar (29 vs. 31). LGBP patients returned to normal activities sooner and had equivalent QOL outcomes.

Conclusion

Laparoscopic gastric bypass provides certain advantages over open gastric bypass techniques. LOS and time to return to normal activities are shorter and early weight loss results may be superior.

Source:
Courcoulas A, Perry Y, Buenaventura P, Luketich J. Department of Thoracic and Foregut Surgery, University of Pittsburgh School of Medicine, PA, 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