Initial Evaluation of Laparoscopic Roux-en-Y Gastric Bypass and Adjustable Gastric Banding in Korea: A Single Institution Study
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
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.
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.
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.
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.
- 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. 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
- Lee WJ, Wang W. Bariatric Surgery: Asia-Pacific Perspective. Obes Surg. 2005;15:751–7. CrossRef
- Korea National Health and Nutrition Examination Survey III 2005. www.mohw.go.kr/.
- 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
- 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. CrossRef
- 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. CrossRef
- 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. CrossRef
- 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. CrossRef
- 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. CrossRef
- Metropolitan Height and Weight Tables. New York: Metropolitan Life Foundation. Stat Bull. 1983;64(1):2–9.
- 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. CrossRef
- Park YW, Allison DB, Heymsfield SB, et al. Larger amounts of visceral adipose tissue in Asian Americans. Obes Res. 2001;9:381–7. CrossRef
- 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. CrossRef
- 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. CrossRef
- Cummings DE, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89:2608–15. CrossRef
- 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. CrossRef
- Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37. CrossRef
- 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. CrossRef
- 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. CrossRef
- 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.
- 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. CrossRef
- Initial Evaluation of Laparoscopic Roux-en-Y Gastric Bypass and Adjustable Gastric Banding in Korea: A Single Institution Study
Volume 20, Issue 8 , pp 1096-1101
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- In Korea
- Early impact on comorbidities
- Industry Sectors
- Author Affiliations
- 1. Division of Laparoscopic & Bariatric Surgery, Department of Surgery, St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, South Korea
- 2. Division of Gastroenterology, Department of Internal Medicine, Kang Nam St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-dong Seocho-gu, Seoul, 137-701, South Korea