title: Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss.
abstract: The purpose of the study was to compare weight loss, metabolic parameters, and postoperative complications in patients undergoing Roux-en-Y gastric bypass (GB) and sleeve gastrectomy (SG).
  
  
  
  We retrospectively studied 30-day postoperative complications as well as change in weight, blood pressure, cholesterol, hemoglobin, hemoglobin A1C, and creatinine from baseline to 2, 6, 12, and 24 months postoperatively in 383 patients undergoing GB and 336 patients undergoing SG at the University of Michigan from January 2008 to November 2013. For a study population which typically has high attrition rates, there were excellent follow-up rates (706/719 at 2 months, 566/719 at 6 months, 519/719 at 12 months, and 382/719 at 24 months).
  
  
  
  Baseline characteristics were similar in both groups except for higher weight and BMI in the SG group. The GB group experienced greater total body weight loss at 6, 12, and 24 months (41.9 vs. 34.6 kg at 24 months, p < 0.0001). Excess weight loss was 69.7 and 51.7 % following GB and SG respectively at 24 months (p < 0.0001). BP improved significantly in both groups. Surgical complication rates were greater after GB (10.1 vs. 3.5 %, p = 0.0007) with no significant difference in life-threatening or potentially life-threatening complications.
  
  
  
  Weight loss was greater following GB compared to SG at 2 years. The risk for surgical complications was greater following GB. Surgical intervention should be tailored to surgical risk, comorbidities, and desired weight loss.
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes (MEND), University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA.
authors.forename: Corey J
authors.initials: CJ
authors.lastname: Lager
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes (MEND), University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA.
authors.forename: Nazanene H
authors.initials: NH
authors.lastname: Esfandiari
authors.affiliation: Division of Endocrinology, University of Mississipi, Jackson, MS, USA.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Subauste
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes (MEND), University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Kraftson
authors.affiliation: Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, 48109, MI, USA.
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, University of Michigan, Ann Arbor, 48109, MI, USA.
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Cassidy
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes (MEND), University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA.|Division of Minimally Invasive Surgery, Department of Surgery, University of Michigan, Ann Arbor, 48109, MI, USA.
authors.forename: Catherine K
authors.initials: CK
authors.lastname: Nay
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes (MEND), University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA.|Division of Minimally Invasive Surgery, Department of Surgery, University of Michigan, Ann Arbor, 48109, MI, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Lockwood
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, University of Michigan, Ann Arbor, 48109, MI, USA.
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Varban
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes (MEND), University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA. eliforal@umich.edu.
authors.forename: Elif A
authors.initials: EA
authors.lastname: Oral
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
keywords: Bariatric surgery; Metabolism; Obesity; Surgical complications; Weight loss