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Obesity Surgery

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01-01-2008 | Research Article

Comparison of Weight Loss and Morbidity after Gastric Bypass and Gastric Banding. A Single Center European Experience

Authors: W. W. te Riele, J. M. Vogten, D. Boerma, M. J. Wiezer, B. van Ramshorst

Published in: Obesity Surgery | Issue 1/2008

Abstract

Background

Gastric bypass and gastric banding are widely used to treat morbid obesity and both procedures offer certain advantages. The indication for these two treatment options continue to be subject to debate.

Methods

A single-center case-controlled matched-pair cohort study was performed. Fifty-three primary gastric bypass patients (GB) operated between January 2002 and May 2005 were matched by gender, age, race, and initial bodyweight to 53 patients who underwent laparoscopic adjustable gastric banding (LAGB) in the same time period.

Results

Both groups were comparable regarding age, race, gender, preoperative body mass index, and excessive weight. Severe early complications occurred in six patients (11.3%) in the GB group and were not seen in the LAGB group. Severe late complications occurred in three patients (5.7%) in the GB group and one patient (1.9%) in the LAGB group. No mortality occurred in either group. Weight loss was significantly lower in the LAGB group than in the GB group at all time points during the follow-up. Significantly more patients were treated successfully (excess weight loss >50%) in the GB group than in the LAGB group. After 2 years, 76% of the patients in the GB group were treated successfully versus 40% of the patients in the LAGB group (P = 0.03).

Conclusion

Gastric bypass and gastric banding are safe and without mortality. Gastric bypass is more effective in terms of weight loss and the number of successfully treated patients. Gastric banding is a procedure with less severe complications.

Deitel M. Overweight and obesity worldwide now estimated to involve 1.7 billion people. Obes Surg 2003;13:329–30.PubMedCrossRef

O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med 2006;144:625–33.PubMed

Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292:1724–37.PubMedCrossRef

Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683–93.PubMedCrossRef

Angrisani L, Furbetta F, Doldi SB, et al. Lap Band adjustable gastric banding system: the Italian experience with 1863 patients operated on 6 years. Surg Endosc 2003;17:409–12.PubMedCrossRef

Ponce J, Paynter S, Fromm R. Laparoscopic adjustable gastric banding: 1,014 consecutive cases. J Am Coll Surg 2005;201:529–35.PubMedCrossRef

Szold A, bu-Abeid S. Laparoscopic adjustable silicone gastric banding for morbid obesity: results and complications in 715 patients. Surg Endosc 2002;16:230–3.PubMedCrossRef

Suter M, Giusti V, Heraief E, et al. Laparoscopic gastric banding. Surg Endosc 2003;17:1418–25.PubMedCrossRef

Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232:515–29.PubMedCrossRef

10.

Podnos YD, Jimenez JC, Wilson SE, et al. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg 2003;138:957–61.PubMedCrossRef

11.

Shikora SA, Kim JJ, Tarnoff ME, et al. Laparoscopic Roux-en-Y gastric bypass: results and learning curve of a high-volume academic program. Arch Surg 2005;140:362–7.PubMedCrossRef

12.

McCarty TM, Arnold DT, Lamont JP, et al. Optimizing outcomes in bariatric surgery: outpatient laparoscopic gastric bypass. Ann Surg 2005;242:494–8.PubMed

13.

Nguyen NT, Rivers R, Wolfe BM. Factors associated with operative outcomes in laparoscopic gastric bypass. J Am Coll Surg 2003;197:548–55.PubMedCrossRef

14.

Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 2006;16:829–35.PubMedCrossRef

15.

DeMaria EJ, Schauer P, Patterson E, et al. The optimal surgical management of the super-obese patient: the debate. Presented at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons, Hollywood, Florida, USA, April 13–16, 2005. Surg Innov 2005;12:107–21.PubMedCrossRef

16.

NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med 1991;115:956–61.

17.

Fried M, Miller K, Kormanova K. Literature review of comparative studies of complications with Swedish band and Lap-Band. Obes Surg 2004;14:256–60.PubMedCrossRef

18.

Belachew M, Legrand M, Vincenti V, et al. Laparoscopic placement of adjustable silicone gastric band in the treatment of morbid obesity: how to do it. Obes Surg 1995;5:66–70.PubMedCrossRef

19.

O’Brien PE, Dixon JB, Laurie C, et al. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg 2005;15:820–6.PubMedCrossRef

20.

Robinett-Weiss N, Hixson ML, Keir B, et al. The metropolitan height–weight tables: perspectives for use. J Am Diet Assoc 1984;84:1480–1.PubMed

21.

Reinhold RB. Critical analysis of long term weight loss following gastric bypass. Surg Gynecol Obstet 1982;155:385–94.PubMed

22.

Kim TH, Daud A, Ude AO, et al. Early U.S. outcomes of laparoscopic gastric bypass versus laparoscopic adjustable silicone gastric banding for morbid obesity. Surg Endosc 2006;20:202–9.PubMedCrossRef

23.

Weber M, Muller MK, Bucher T, et al. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg 2004;240:975–82.PubMedCrossRef

24.

Cottam DR, Atkinson J, Anderson A, et al. A case-controlled matched-pair cohort study of laparoscopic Roux-en-Y gastric bypass and Lap-Band patients in a single US center with three-year follow-up. Obes Surg 2006;16:534–40.PubMedCrossRef

25.

Jan JC, Hong D, Pereira N, et al. Laparoscopic adjustable gastric banding versus laparoscopic gastric bypass for morbid obesity: a single-institution comparison study of early results. J Gastrointest Surg 2005;9:30–9.PubMedCrossRef

26.

Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326–51.PubMedCrossRef

27.

Chevallier JM, Zinzindohoue F, Douard R, et al. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg 2004;14:407–14.PubMedCrossRef

28.

Holeczy P, Novak P, Kralova A. 30% complications with adjustable gastric banding: what did we do wrong? Obes Surg 2001;11:748–51.PubMedCrossRef

29.

Niville E, Dams A. Late pouch dilation after laparoscopic adjustable gastric and esophagogastric banding: incidence, treatment, and outcome. Obes Surg 1999;9:381–4.PubMedCrossRef

30.

O’Brien PE, Dixon JB. Laparoscopic adjustable gastric banding in the treatment of morbid obesity. Arch Surg 2003;138:376–82.PubMedCrossRef

31.

Weiner R, Blanco-Engert R, Weiner S, et al. Outcome after laparoscopic adjustable gastric banding—8 years experience. Obes Surg 2003;13:427–34.PubMedCrossRef

32.

Dargent J. Pouch dilatation and slippage after adjustable gastric banding: is it still an issue? Obes Surg 2003;13:111–5.PubMedCrossRef

33.

Fernandez AZ Jr, DeMaria EJ, Tichansky DS, et al. Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity. Ann Surg 2004;239:698–702.PubMedCrossRef

34.

Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg 2001;234:279–89.PubMedCrossRef

35.

Lean ME, Powrie JK, Anderson AS, et al. Obesity, weight loss and prognosis in type 2 diabetes. Diabet Med 1990;7:228–33.PubMedCrossRef

36.

Lavie CJ, Milani RV. Effects of cardiac rehabilitation, exercise training, and weight reduction on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in obese coronary patients. Am J Cardiol 1997;79:397–401.PubMedCrossRef

Title: Comparison of Weight Loss and Morbidity after Gastric Bypass and Gastric Banding. A Single Center European Experience
Authors: W. W. te Riele
J. M. Vogten
D. Boerma
M. J. Wiezer
B. van Ramshorst
Publication date: 01-01-2008
Publisher: Springer-Verlag
Published in: Obesity Surgery / Issue 1/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-007-9254-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of Weight Loss and Morbidity after Gastric Bypass and Gastric Banding. A Single Center European Experience

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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