Published in:
01-12-2012 | Original Article
Complications and outcome after laparoscopic bariatric surgery: LAGB versus LRYGB
Published in: Langenbeck's Archives of Surgery | Issue 8/2012
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Background and aims
Unsatisfactory patient compliance and unfavorable results of weight loss let centers prefer the Roux-en-Y gastric bypass (RYGB) as a combined restrictive and malabsorptive procedure. The aim of this study was to evaluate results of laparoscopic adjustable gastric banding (LAGB) versus laparoscopic RYGB.
Setting
The study was conducted at Centre Hospitalier Emil Mayrisch Clinic for specialized care (n = 618 beds) in Luxembourg (South).
Materials and methods
Of 620 procedures, 204 patients had LAGB and 416 LRYGB. Short-term (t
1, 6 months to 2 years), middle-term (t2, 2 to 5 years), and long-term follow-up (t
3, >5 years) were performed, including weight loss evolution, Bariatric Analysis, and Reporting Outcome System (BAROS).
Results
Percent EBWL mean values for LAGB vs. LRYGB were at t
1 64.3 vs. 79.5, p = 0.01; at t
2 49.4 vs. 91, p < 0.0001; and at t3 52.6 vs. 79.9, p < 0.0001. The BAROS mean values were at t
1 3.81 vs. 4.00, p = 0.183; at t
2 3.57 vs. 4.12, p < 0.001; and at t
3 3.71 vs. 4.04, p = 0.02. Major complication rate (<30 days) was similar (p = 0.601). Long-term (>30 days) complications were more common after LAGB (14.3 versus 3.6 %, p < 0.001). Fifty patients (25 %) required a second and 36 patients (18 %) a third operation (LRYGB).
Conclusion
The significant difference in %EBWL and BAROS and late adverse events with high re-operation rates in LAGB made the LRYGB more attractive.