Comparative study on laparoscopic sleeve gastrectomy and laparoscopic gastric bypass for treatment of morbid obesity patients.

BACKGROUND/AIMS: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures for the treatment of morbid obesity. Laparoscopic sleeve gastrectomy (LSG) is a relatively innovative procedure which has been increasingly accepted as a sole bariatric procedure in the Asian-Pacific region. This study aims to compare mid-term outcomes in morbid obesity patients undergoing LRYGB and LSG.

METHODOLOGY

Between January 2008 and May 2011, 94 morbid obesity patients were assigned by patient choice after informed consent to either a LSG (n = 56) or LRYGB (n = 38) group. We compared operation time, amount of bleeding, hospital length-of-stay, complications, improvement of diabetic patients, BMI, and excess weight loss (EWL) at 6-30 months post-operation.

RESULTS

There was no death in either group. The operating time, hospital length-of-stay, and complications were significantly shorter in the LSG group (P < 0.05). There was no significant difference in the overall improvement of diabetes mellitus (P > 0.05). LRYGB had better effectiveness than LSG in BMI decrease and EWL in the first year (P < 0.05), but there was no significant difference after 1 year (P > 0.05).

CONCLUSIONS

The two procedures are safe and effective, but the LRYGB procedure incurs a high number of complications and long hospital stay. LSG is a promising bariatric procedure and the results of LSG as a single procedure are equally effective to LRYGB at 2 years follow-up on weight reduction. Furthermore, the LSG group has a more stable EWL in the early stage. However, studies with large number of patients and longer follow-up are necessary to make a definitive conclusions.