title: Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic biliopancreatic diversion with duodenal switch (LDS) are surgical options for superobesity. A randomized trial was conducted to evaluate perioperative (30-day) safety and 1-year results.
  
  
  METHODS
  Sixty patients with a body mass index (BMI) of 50-60 kg/m(2) were randomized to LRYGB or LDS. BMI, percentage of excess BMI lost, complications and readmissions were compared between groups.
  
  
  RESULTS
  Patient characteristics were similar in the two groups. Mean operating time was 91 min for LRYGB and 206 min for LDS (P < 0.001). One LDS was converted to open surgery. Early complications occurred in four patients undergoing LRYGB and seven having LDS (P = 0.327), with no deaths. Median stay was 2 days after LRYGB and 4 days after LDS (P < 0.001). Four and nine patients respectively had late complications (P = 0.121). Mean BMI at 1 year decreased from 54.8 to 38.5 kg/m(2) after LRYGB and from 55.2 to 32.5 kg/m(2) after LDS; percentage of excess BMI lost was greater after LDS (74.8 versus 54.4 per cent; P < 0.001).
  
  
  CONCLUSIONS
  LRYGB and LDS can be performed with comparable perioperative safety in superobese patients. LDS provides greater weight loss in the first year.
authors.affiliation: Departments of Gastrointestinal Surgery, Oslo University Hospital Aker, Oslo, Norway. t.t.sovik@medisin.uio.no
authors.forename: T T
authors.initials: TT
authors.lastname: Søvik
authors.forename: O
authors.initials: O
authors.lastname: Taha
authors.forename: E T
authors.initials: ET
authors.lastname: Aasheim
authors.forename: M
authors.initials: M
authors.lastname: Engström
authors.forename: J
authors.initials: J
authors.lastname: Kristinsson
authors.forename: S
authors.initials: S
authors.lastname: Björkman
authors.forename: C F
authors.initials: CF
authors.lastname: Schou
authors.forename: H
authors.initials: H
authors.lastname: Lönroth
authors.forename: T
authors.initials: T
authors.lastname: Mala
authors.forename: T
authors.initials: T
authors.lastname: Olbers
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004386:Duodenum / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome