Laparoscopic adjustable gastric band versus laparoscopic Roux-en-Y gastric bypass: Ends justify the means?

Carlos A Galvani, M. Gorodner, F. Moser, M. Baptista, C. Chretien, R. Berger, S. Horgan

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: In the United States, the most frequently performed bariatric procedure is the Roux-en-Y gastric bypass (RYGB). Worldwide, the most common operation performed is the laparoscopic adjustable gastric band (LAGB). The expanding use of LAGB is probably driven by the encouraging data on its safety and effectiveness, in contrast to the disappointing morbidity and mortality rates reported for RYGB. The aim of this study was to evaluate the results of LAGB versus RYGB at a single institution. Methods: Between November 2000 and July 2004, 590 bariatric procedures were performed. Of these, 120 patients (20%) had laparoscopic RYGB and 470 patients (80%) had LAGB. A retrospective review was performed. Results: In the LAGB group, 376 patients (80%) were female, and the mean age was 41 years (range, 17-65). In the RYGB group, 110 patients (91%) were female, and the mean age was 41 years (range, 20-61). Preoperative body mass index was 47 ± 8 and 46 ± 5, respectively (p = not significant). Operative time and hospitalization were significantly shorter in LAGB patients (p < 0.001). Complications and the need for reoperation were comparable in both groups. Weight loss at 12, 18, 24, and 36 months for LAGB and RYGB was 39 ± 21 versus 65 ± 13, 39 ± 20 versus 62 ± 17, 45 ± 25 versus 67 ± 8, and 55 ± 20 versus 63 ± 9, respectively. Conclusions: The current study demonstrates that LAGB is a simpler, less invasive, and safer procedure than RYGB. Although mean percentage excess body weight loss (%EBWL) in RYGB patients increased rapidly during the first postoperative year, it remained nearly unchanged at 3 years. In contrast, in LAGB patients weight loss was slower but steady, achieving satisfactory %EBWL at 3 years. Therefore, we believe that LAGB should be considered the initial approach since it is safer than RYGB and is very effective at achieving weight loss.

Original languageEnglish (US)
Pages (from-to)934-941
Number of pages8
JournalSurgical Endoscopy
Volume20
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

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Gastric Bypass
Stomach
Weight Loss
Bariatrics
Operative Time
Reoperation
Hospitalization
Body Mass Index
Body Weight
Morbidity
Safety

Keywords

  • Laparoscopic adjustable gastric band
  • Morbid obesity
  • Morbidity/Mortality
  • Roux-en-Y gastric bypass
  • Weight loss

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic adjustable gastric band versus laparoscopic Roux-en-Y gastric bypass : Ends justify the means? / Galvani, Carlos A; Gorodner, M.; Moser, F.; Baptista, M.; Chretien, C.; Berger, R.; Horgan, S.

In: Surgical Endoscopy, Vol. 20, No. 6, 06.2006, p. 934-941.

Research output: Contribution to journalArticle

Galvani, Carlos A ; Gorodner, M. ; Moser, F. ; Baptista, M. ; Chretien, C. ; Berger, R. ; Horgan, S. / Laparoscopic adjustable gastric band versus laparoscopic Roux-en-Y gastric bypass : Ends justify the means?. In: Surgical Endoscopy. 2006 ; Vol. 20, No. 6. pp. 934-941.
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AU - Chretien, C.

AU - Berger, R.

AU - Horgan, S.

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