title: Better weight loss, resolution of diabetes, and quality of life for laparoscopic gastric bypass vs banding: results of a 2-cohort pair-matched study.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic gastric banding (LB) are the 2 most common operations used to treat morbid obesity, but few controlled comparative studies have reported perioperative and long-term outcomes.
  
  
  METHODS
  Two-cohort pair-matched study.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  One hundred consecutive morbidly obese patients treated with LB were pair-matched by sex, race, age, initial body mass index, and presence of type 2 diabetes mellitus with 100 patients who were treated with RYGB.
  
  
  METHODS
  Perioperative and postoperative complications, reoperations, and 1-year outcomes, including weight loss, type 2 diabetes resolution, and quality of life.
  
  
  RESULTS
  The RYGB and LB groups had similar characteristics. One-year outcomes were available for 93 patients in the LB group and 92 in the RYGB group. The overall rate of complications was similar in both groups (11 patients in the LB group [12%] vs 14 in the RYGB group [15%]; P = .83), with a higher rate of early complications (≤ 30 days) after RYGB (11 patients [11%] vs 2 [2%] for LB; P = .01) and a higher rate of reoperations after LB (12 patients [13%] vs 2 for RYGB [2%]; P = .009). No deaths occurred. Excess weight loss (36% vs 64%; P < .01), resolution of diabetes (17 patients [50%] vs 26 [76%]; P = .04), and quality-of-life measures were better in the RYGB group.
  
  
  CONCLUSIONS
  When performed in high-volume centers by expert surgeons, RYGB has a similar rate of overall complications and lower rate of reoperations than LB. With the benefit of greater weight loss, increased resolution of diabetes, and improved quality of life, RYGB, in these circumstances, has a better risk-benefit profile than LB.
authors.affiliation: Department of Surgery, University of California, San Francisco, USA. campos@surgery.wisc.edu
authors.forename: Guilherme M
authors.initials: GM
authors.lastname: Campos
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rabl
authors.forename: Garrett R
authors.initials: GR
authors.lastname: Roll
authors.forename: Sofia
authors.initials: S
authors.lastname: Peeva
authors.forename: Kris
authors.initials: K
authors.lastname: Prado
authors.forename: Jessica
authors.initials: J
authors.lastname: Smith
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult