Acta Diabetologica

, Volume 56, Issue 2, pp 163–169 | Cite as

A 9 years comparison of weight loss, disappearance of obesity, and resolution of diabetes mellitus with biliointestinal bypass and with adjustable gastric banding: experience of a collaborative network

  • Antonio E. PontiroliEmail author
  • Ahmed S. Zakaria
  • Giancarlo Micheletto
  • Chiara Osio
  • Alessandro Saibene
  • Franco Folli
  • On Behalf of the LAGB10 Group
Original Article



Long-term comparisons between bariatric surgical techniques have been performed for gastric bypass (RYGB), sleeve gastrectomy (LSG), and biliopancreatic diversion (BPD) vs gastric banding (LAGB), but short-term studies (6 months–4 years) have only compared biliointestinal bypass (BIBP) and LAGB. The participating institutions regularly perform both BIBP and LAGB with a common protocol, and the aim of this retrospective study was to compare long-term effects of the two procedures on body weight, on clinical and metabolic variables, and on resolution of obesity and of diabetes.


All procedures performed between 01/01/1998 and 31/12/2005 were considered; 73 out of 91 patients undergoing BIBP, and 154 out of 249 patients undergoing LAGB were evaluable up to 9 years.


BIBP was significantly more effective than LAGB in terms of weight loss and of resolution of obesity (BMI < 30 kg/m2), in terms of decrease of systolic blood pressure and of serum cholesterol, and similar in terms of resolution of diabetes. In addition, the effect of BIBP was stable, while the effect of LAGB decreased with time.


Both BIBP and LAGB exert long-term effects on body weight, on blood pressure, and on resolution of diabetes mellitus; the effect of BIBP is significantly greater than the effect of LAGB in terms of weight loss, resolution of obesity, of control of systolic blood pressure and of serum cholesterol, but not in terms of resolution of diabetes.


Biliointestinal bypass Adjustable gastric banding Obesity Bariatric surgery Diabetes mellitus Resolution of diabetes mellitus Resolution of obesity 



The LAGB10 working group includes people from Ospedale San Paolo (Annamaria Veronelli MD, Barbara Zecchini BSc, Ahmed Zakaria Ph.D., Francesca Frigè B.Sc., Luca Rossetti MD, Alberto Benetti MD, Maurizio Cristina MD, Ermanno Mantegazza B.Sc., Marco Fanchini B.Sc., Alberto Morabito Ph.D., Franco Folli MD, and Antonio E. Pontiroli MD), from IRCCS Policlinico (Enrico Mozzi MD), Ospedale San Raffaele (Alessandro Saibene MD, Michele Paganelli MD, Paola Vedani MD), from Istituto Clinico Sant’Ambrogio (Giancarlo Micheletto MD, Alessandro Giovanelli MD), from Istituto Multimedica (Valerio Ceriani MD, Chiara Osio MD), from Ospedale Civile, Magenta (Giuliano Sarro MD), from Istituto Humanitas Gavazzeni (Italo Nosari MD), and from the Health Districts (Maria Grazia Angeletti MD, Mariangela Autelitano MD, Luca Cavalieri d’Oro MD, Piergiorgio Berni MD, Antonio G. Russo MD).


Università degli Studi di Milano, Ospedale San Paolo, Istituto Clinico Sant’Ambrogio, Ospedale San Raffaele, Istituto Multimedica. Grant “Ricerca Corrente” to IRCCS Istituto Multimedica from Ministero della Salute (Ministry of Health), Italy.

Compliance with ethical standards

Conflict of interest

All authors declare that they no conflict of interest.

Statement of human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed Consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Dipartimento di Scienze della SaluteUniversità degli Studi di MilanoMilanItaly
  2. 2.Ospedale San PaoloMilanItaly
  3. 3.Dipartimento di Fisiopatologia Medico-Chirurgica e dei TrapiantiUniversità degli Studi di MilanoMilanItaly
  4. 4.UOC Chirurgia Generale e INCO Istituto Clinico Sant’AmbrogioMilanItaly
  5. 5.Istituto MultimedicaMilanItaly
  6. 6.Ospedale San RaffaeleMilanItaly

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