Short- and Midterm Results between Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity

Abstract

Background. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular in Europe. The aim of this study was to compare short- and midterm results between LRYGB and LSG. Methods. An observational retrospective study from a database of patients undergoing LRYGB and LSG between January 2008 and June 2011. Seventy patients (mean age 39 years) were included. Patients were followed at 6, 12, and 18 months. Operative time, length of stay, weight loss, comorbidity improvement or resolution, postoperative complications, reinterventions and mortality were evaluated. Results. Thirty-six LRYGB and 34 LSG were included. Mean operative time of LSG was 106 min while LRYGB was 196 min (P < 0.001). Differences in length of stay, early and late complications, and improvement or resolution in comorbidities were not significant (P > 0.05). Eighteen months after surgery, average excess weight loss was 77.6% in LRYGB and 57.1% in LSG (P = 0.003). There was no surgery-related mortality. Conclusions. Both LRYGB and LSG are safe procedures that provide good results in weight loss and resolution of comorbidities at 18 months.

Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch

“…However, over the last decade the LSG gained popularity as primary bariatric procedure, due to its lower operative complexity, relative safety and excellent weight loss in the short term [1,2]. The percentage excess weight loss (%EWL) after 12 months is comparable to the laparoscopic Roux-en-Y gastric bypass (LRYGB) and can reach over 70% [3][4][5][6][7][8]. Therefore, the LSG has the potential to become the "gold standard" for bariatric procedures instead of the LRYGB.…”

A Sleeve Gastrectomy Complicated by Mesenteric Vein Thrombosis, Abdominal Compartment Syndrome and Pulmonary Emboli: Case Report

“…However, in those where DMII was not resolved, the medication dosage was decreased. Hypertension was resolved in 53.8% of patients with LSG vs. 46.7% with the patients who underwent LRYGB [7]. Having some of these major comorbidities resolve is very favourable for LSG surgery.…”

“…It is considered easier, faster, and less traumatic to perform for surgeons than laparoscopic Roux-en-Y gastric bypass (LRYGB) [7] . Bariatric surgery is the only evidence based treatment of morbid obesity with proven and sustained weight loss and improvement in comorbidities [8][9][10].…”

“…Obesity associated with non-alcoholic fatty liver disease can also be resolved after bariatric surgery [11]. Some of the advantages include preservation of endoscopic access to the upper gastrointestinal tract, the lack of an intestinal anastomosis thus excluding the risk of internal herniation, normal intestinal absorption and prevention of dumping syndrome due to pylorus preservation [7]. B. Albeladi et al [7] found that DMII was resolved in 100% of the patients in the LSG vs. 85.7% in the LRYGB group.…”

“…Having some of these major comorbidities resolve is very favourable for LSG surgery. LSG is also less complex than LRYGB, and leads to a slower operative time as well [7].…”