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Published in: Obesity Surgery 8/2010

01-08-2010 | Research Article

Initial Evaluation of Laparoscopic Roux-en-Y Gastric Bypass and Adjustable Gastric Banding in Korea: A Single Institution Study

Authors: Hongchan Lee, Dohyoung Kim, Sangkuon Lee, Kwanwoo Nam, Eungkook Kim

Published in: Obesity Surgery | Issue 8/2010

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Abstract

Background

Obesity becomes a global epidemic disease, and bariatric surgery is increasing in Korea as well as in western countries. The first laparoscopic Roux-en-Y gastric bypass (LRYGBP) was performed in 2003, and the Lap Band® was approved for use in Korea in 2004. There are no data regarding gastric bypass and adjustable gastric banding regarding weight loss as well as changing of pre-existing comorbidities up to date.

Methods

St. Mary’s Hospital Center, main leader of bariatric surgery in Korea, performed 76 weight loss operations [LRYGBP = 25, laparoscopic adjustable gastric banding (LAGB)  = 51] for morbid obesity. We retrospectively reviewed a series of bariatric cases and examined changes of weight loss, postoperative complications, and pre-existing comorbidities between two procedures.

Results

There were no significant differences in age, BMI, sex distribution, pre-existing comorbidities in two procedures. Patients undergoing LRYGBP had longer operative times, more blood loss, and longer hospital stays. There is significant difference regarding postoperative complication (p < 0.05) but neither for mortality nor pulmonary embolism with both procedures. Percentage of excess weight loss (%EWL) of LRYGBP at 12, 24, and 36 months were 76.9%, 79.7%, and 85.8%, and %EWL of LAGB were 46.8%, 55.1%, 63.3%, respectively. The patients in the LRYGBP who has dyslipidemia, sleep apnea, degenerative joint disease, and diabetes mellitus were more likely to improve than the patients after LAGB at early postoperative period.

Conclusions

The results of our initial study indicate that LRYGBP and LAGB are technically feasible and safe. It is a low rate of major postoperative complications without mortality. LRYGBP and LAGB are quite satisfactory and promising bariatric procedures with significant weight loss and improvement of obesity-related metabolic comorbidities in Korean.
Literature
1.
go back to reference Ramachandran A, Snehalatha C, Viswanathan V, et al. Risk of noninsulin dependent diabetes mellitus conferred by obesity and central adiposity in different ethnic groups: a comparative analysis between Asian Indians, Mexican Americans and Whites. Diabetes Res Clin Pract. 1997;36:121–5.CrossRefPubMed Ramachandran A, Snehalatha C, Viswanathan V, et al. Risk of noninsulin dependent diabetes mellitus conferred by obesity and central adiposity in different ethnic groups: a comparative analysis between Asian Indians, Mexican Americans and Whites. Diabetes Res Clin Pract. 1997;36:121–5.CrossRefPubMed
2.
go back to reference Hughes K, Aw TC, Kuperan P, et al. Central obesity, Insulin resistance, syndrome X, Lipoprotein(a), and cardiovascular risk in Indians, Malays and Chinese in Singapore. J Epidemiol Community Health. 1998;52:764–5.CrossRef Hughes K, Aw TC, Kuperan P, et al. Central obesity, Insulin resistance, syndrome X, Lipoprotein(a), and cardiovascular risk in Indians, Malays and Chinese in Singapore. J Epidemiol Community Health. 1998;52:764–5.CrossRef
5.
go back to reference McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991;16:382–6.CrossRef McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991;16:382–6.CrossRef
6.
go back to reference Misra A, Vikram NK, Arya S, et al. High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord. 2004;28:1217–26.CrossRefPubMed Misra A, Vikram NK, Arya S, et al. High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord. 2004;28:1217–26.CrossRefPubMed
7.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
8.
go back to reference DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–5.CrossRefPubMed DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–5.CrossRefPubMed
9.
go back to reference O’Brien PE, Dixon JB, Baquie P. The laparoscopic adjustable gastric band (Lap-Band): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002;12:652–60.CrossRefPubMed O’Brien PE, Dixon JB, Baquie P. The laparoscopic adjustable gastric band (Lap-Band): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002;12:652–60.CrossRefPubMed
10.
go back to reference Chevallier JM, Zinzindohoué F, Cugnenc PH, 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.CrossRefPubMed Chevallier JM, Zinzindohoué F, Cugnenc PH, 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.CrossRefPubMed
11.
go back to reference Metropolitan Height and Weight Tables. New York: Metropolitan Life Foundation. Stat Bull. 1983;64(1):2–9. Metropolitan Height and Weight Tables. New York: Metropolitan Life Foundation. Stat Bull. 1983;64(1):2–9.
12.
go back to reference Lear SA, Humphries KH, Kohli S, et al. The use of BMI and waist circumference as surrogates of body fat differs by ethnicity. Obesity. 2007;15:2817–24.CrossRefPubMed Lear SA, Humphries KH, Kohli S, et al. The use of BMI and waist circumference as surrogates of body fat differs by ethnicity. Obesity. 2007;15:2817–24.CrossRefPubMed
13.
go back to reference Park YW, Allison DB, Heymsfield SB, et al. Larger amounts of visceral adipose tissue in Asian Americans. Obes Res. 2001;9:381–7.CrossRefPubMed Park YW, Allison DB, Heymsfield SB, et al. Larger amounts of visceral adipose tissue in Asian Americans. Obes Res. 2001;9:381–7.CrossRefPubMed
14.
go back to reference O’Brien PE, Laurie C, Anderson M, 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.CrossRefPubMed O’Brien PE, Laurie C, Anderson M, 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.CrossRefPubMed
15.
go back to reference Rubino F, Cummings DE, Vix M, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg. 2006;244:741–9.CrossRefPubMed Rubino F, Cummings DE, Vix M, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg. 2006;244:741–9.CrossRefPubMed
16.
go back to reference Cummings DE, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89:2608–15.CrossRefPubMed Cummings DE, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89:2608–15.CrossRefPubMed
17.
go back to reference Spivak H, Onn A, Half EE, et al. Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg. 2005;189:27–32.CrossRefPubMed Spivak H, Onn A, Half EE, et al. Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg. 2005;189:27–32.CrossRefPubMed
18.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMed
19.
go back to reference Sugerman HJ, Sica DA, Clore JN. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237:751–6.CrossRefPubMed Sugerman HJ, Sica DA, Clore JN. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237:751–6.CrossRefPubMed
20.
go back to reference Dixon JB, O’Brien PE. Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg. 2002;184:51S–4S.CrossRefPubMed Dixon JB, O’Brien PE. Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg. 2002;184:51S–4S.CrossRefPubMed
21.
go back to reference Clements RH, Long CI, Wittert G, et al. Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. Am Surg. 2004;70:1–4.PubMed Clements RH, Long CI, Wittert G, et al. Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. Am Surg. 2004;70:1–4.PubMed
22.
go back to reference Laferrère B, Teixeira J, Olivan B, et al. Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes. Diabetes Care. 2007;30:1709–16.CrossRefPubMed Laferrère B, Teixeira J, Olivan B, et al. Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes. Diabetes Care. 2007;30:1709–16.CrossRefPubMed
Metadata
Title
Initial Evaluation of Laparoscopic Roux-en-Y Gastric Bypass and Adjustable Gastric Banding in Korea: A Single Institution Study
Authors
Hongchan Lee
Dohyoung Kim
Sangkuon Lee
Kwanwoo Nam
Eungkook Kim
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 8/2010
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9528-5

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