Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding in the super-obese: a comparative study of 290 patients.
BACKGROUND
Controversy exists regarding the best surgical treatment for super-obesity (BMI >50 kg/m2). The two most common bariatric procedures performed worldwide are laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGBP). We undertook a retrospective single-center study to compare the safety and efficacy of these two operations in super-obese patients.


METHODS
290 super-obese patients underwent laparoscopic bariatric surgery: 179 LAGB and 111 LRYGBP.


RESULTS
There were one death in both groups. The early complication rate was higher in the LAGB group (10% vs 2.8%, P<0.01). Late complication rate was higher in the LAGB group (26% vs 15.3%, P<0.05). Operating time and hospital stay were significantly higher in the LRYGBP group. LRYGBP had significantly better excess weight loss than LAGB (63% vs 41% at 1 year, and 73% vs 46% at 2 years), as well as lower BMI than LAGB (35 vs 41 at 18 months).


CONCLUSIONS
LRYGBP results in significantly greater weight loss than LAGB in super-obese patients, but is associated with a higher early complication rate.
Mognol
Philippe
P
Service de Chirurgie Générale A, Hôpital Bichat, Paris, France. philippe.mognol@bch.ap-hop-paris.fr
Chosidow
Denis
D
Marmuse
Jean-Pierre
JP
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D015431:Weight Loss