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Type: Journal article
Title: Outcomes of Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding
Author: Nguyen, Q.
Game, P.
Bessell, J.
Debreceni, T.
Neo, M.
Burgstad, C.
Taylor, P.
Wittert, G.
Citation: World Journal of Gastroenterology, 2013; 19(36):6035-6043
Publisher: W J G Press
Issue Date: 2013
ISSN: 1007-9327
Statement of
Nam Q Nguyen, Philip Game, Justin Bessell, Tamara L Debreceni, Melissa Neo, Carly M Burgstad, Pennie Taylor, Gary A Wittert
Abstract: <h4>Aim</h4>To evaluate weight loss and surgical outcomes of Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric band (LAGB).<h4>Methods</h4>Data relating to changes in body mass index (BMI) and procedural complications after RYGB (1995-2009; n = 609; 116M: 493F; 42.4 ± 0.4 years) or LAGB (2004-2009; n = 686; 131M: 555F; 37.2 ± 0.4 years) were extracted from prospective databases.<h4>Results</h4>Pre-operative BMI was higher in RYGB than LAGB patients (46.8 ± 7.1 kg/m² vs 40.4 ± 4.2 kg/m², P < 001); more patients with BMI < 35 kg/m² underwent LAGB than RYGB (17.1% vs 4.1%, P < 0.0001). BMI decrease was greater after RYGB. There were direct relationships between weight loss and pre-operative BMI (P < 0.001). Although there was no difference in weight loss between genders during the first 3-year post-surgery, male LAGB patients had greater BMI reduction than females (-8.2 ± 4.3 kg/m² vs -3.9 ± 1.9 kg/m², P = 0.02). Peri-operative complications occurred more frequently following RYGB than LAGB (8.0% vs 0.5%, P < 0.001); majority related to wound infection. LAGB had more long-term complications requiring corrective procedures than RYGB (8.9% vs 2.1%, P < 0.001). Conversion to RYGB resulted in greater BMI reduction (-9.5 ± 3.8 kg/m²) compared to removal and replacement of the band (-6.0 ± 3.0 kg/m²). Twelve months post-surgery, fasting glucose, total cholesterol and low density lipoprotein levels were significantly lower with the magnitude of reduction greater in RYGB patients.<h4>Conclusion</h4>RYGB produces substantially greater weight loss than LAGB. Whilst peri-operative complications are greater after RYGB, long-term complication rate is higher following LAGB.
Keywords: Bariatric surgery; Gastric bypass; Gastric banding; Weight loss; Complications; Co-morbidity; Outcomes
Rights: ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
RMID: 0020132175
DOI: 10.3748/wjg.v19.i36.6035
Appears in Collections:Medicine publications

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