Laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding: five years of follow-up

Background: Bariatric surgery is an effective treatment for morbid obesity Laparoscopic Rouxen-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) are commonly performed procedures The aim of the present study was to evaluate and compare the lone-term outcomes after LRYGB and LAGB Methods: We studied the data from a prospective database of all patients undergoing LRYGB or LAGB with 5 years of follow-up Results: From July 2001 to September 2003, 91 and 62 patients underwent LRYGB and LAGB. respectively. Of these patients. 73 6% of the LRYGB and 91.9% of the LAGB patients had 5 years of follow-up. Of the 91 and 62 patients, 89% and 82% were women, respectively. The mean age and body mass index was 34 5 +/- 11 0 years and 39 6 +/- 4 9 kg/m(2) for the LRYGB group and 38 4 +/- 13 1 years and 35 8 +/- 4 0 kg/m(2) for the LAGB group, respectively. The mean operative time was 150 +/- 58 minutes for LYRGB and 73 +/- 23 minutes for LAGB (P < 05). The conversion and reoperation rate was 8% and 4 3%, respectively, for the LRYGB group versus 0% for the LAGB group Early postoperative complications were observed in 12 and 1 patient (P = 014) after LRYGB and LAGB, respectively. Late complications developed in 33 and 17 patients after LYRGB and LAGB. respectively (P = NS) The percentage of excess weight loss at 5 years postoperatively was 92.9% +/- 25.6% and 59.1% +/- 46 8% (P < 00.1) for LRYGB and LAGB, respectively. Surgical failure (percentage of excess weight loss <50%) at 5 years was 6% for LRYGB and 45 6% for LAGB. A late reoperation was needed in 24 1% of the LAGB patients. Conclusion: A greater percentage of excess weight loss at 1 and 5 years was observed after LRYGB than LAGB. The LAGB group had a >40% rate of surgical failure and a 24 1% reoperation rate at 5 years of follow-up (Surg Obes Relat Dis 2010;6 470-476) (c) 2010 American Society for Metabolic and Bariatric Surgery All rights reserved.