| 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. |
