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Laparoscopic Gastric Bypass vs Gastric Banding for Obesity

Source: Surgical Endoscopy

Early U.S. outcomes of laparoscopic gastric bypass versus laparoscopic adjustable silicone gastric banding for morbid obesity
T. H. Kim1, A. Daud1, A. O. Ude1, M. DiGiorgi1, L. Olivero-Rivera1, B. Schrope1, D. Davis1, W. B. Inabnet1 and M. Bessler1
(1)

Center for Obesity Surgery, New York Presbyterian Hospital, Columbia University, 161 Fort Washington Avenue, Suite 620, New York, NY 10032, USA

Received: 14 April 2005 Accepted: 7 September 2005 Published online: 6 December 2005

Abstract. Laparoscopic gastric bypass (LGBP) is the gold standard operation for long-term weight control in the United States. Laparoscopic adjustable silicone gastric banding (LASGB) is the preferred operative method for morbid obesity worldwide. Limited data are available comparing the two procedure in the United States. This study compares weight loss, complications, and early outcome of comorbidity resolution in patients who underwent LGBP versus LASGB. A review of prospectively collected data was performed on 392 patients undergoing primary LGBP (n = 232) and LASGB (n = 160) procedures between February 2001 and July 2004. Differences in percentage excess weight lost (%EWL) at 3, 6, 12, 18, and 24 months postop, improvement or resolution of comorbidities, and complications across procedure types were evaluated. Mean initial body mass index between groups was not significantly different (LGBP 47.2 vs LASGB 47.1, p < 0.53). There were significant differences in age, gender, and self-reported sweet-eating behavior between operative groups. There was a significantly greater %EWL in patients who underwent LGBP compared to patients of the LASGB groups 3, 6, 12, and 18 months after surgery. There were no significant differences in resolution or improvement of comorbidities between the groups. Although LGBP patients experienced more complications compared to LASGB patients (5.6 vs 4.3%, respectively; p < 0.56), this did not reach statistical significance. Early after surgery, LGBP patients lose more weight than LASGB patients but have similar improvements in comorbidities. Further follow-up is needed to determine the relative long-term efficacy of these procedures.

Keywords Laparoscopic gastric bypass - Laparoscopic gastric banding - Morbid obesity - Percentage excess weight loss Surgical Endoscopy