Skip to main content

Advertisement

SpringerLink
Log in

15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Background

Laparoscopic single anastomosis (mini-)gastric bypass (LSAGB) has been validated as a safe and effective treatment for morbid obesity. However, data of the long-term outcome remain lacking.

Methods

Between October 2001 and December 2015, 1731 morbidly obese patients who received LSAGB as primary bariatric procedure at the Min-Sheng General Hospital were recruited. Surgical outcome, weight loss, resolution of comorbidities, and late complications were followed, then compared with groups of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). All data derived from a prospective bariatric database and a retrospective analysis were conducted.

Results

The average patient age was 33.8 ± 10.4 years with a mean body mass index (BMI) of 40.4 ± 7.7 kg/m2. Of them, 70.0% were female while 30.0% were male. Mean operating time, intraoperative blood, and hospital stay of LSAGB were 124.6 ± 38.8 min, 39.5 ± 38.7 ml, and 5.0 ± 4.1 days, respectively. The 30-day post-operative major complication occurred in 30 (1.7%) of LSAGB patients, 16 (2.0%) of LRYGB, and 15 (1.4%) of LSG patients. The follow-up rates at 1, 5, and 10 years were 89.3, 52.1, and 43.6%, respectively. At postoperative 1, 5, and 10 years, the mean percentage of weight loss (%WL) of LSAGB patients were 32.7, 32.2, and 29.1%, and mean BMI became 27, 26.9, and 27 kg/m2, respectively. The LSAGB had a higher weight loss than LRYGB and LSG at 2–6 years after surgery. LSG had a lower remission rate in dyslipidemia comparing to LSAGB and LRYGB. The overall revision rate of LSAGB is 4.0% (70/1731) which was lower than the 5.1% in LRYGB and 5.2% in the LSG.

Conclusion

LSAGB is an effective procedure for treating morbid obesity and metabolic disorders, which results in sustained weight loss and a high resolution of comorbidities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737

    Article  PubMed  CAS  Google Scholar 

  2. Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Agren G, Carlsson L (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357:741–752

    Article  PubMed  Google Scholar 

  3. Buchwald H, Oien DM (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23(4):427–436

    Article  PubMed  Google Scholar 

  4. Himpens J, Dobbeleir J, Peeters G (2010) Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 252:319–324

    Article  PubMed  Google Scholar 

  5. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N (2015) Bariatric surgery worldwide 2013. Obes Surg 25:1822–1832

    Article  PubMed  CAS  Google Scholar 

  6. Rutledge R (2001) The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg 11(3):276–280. https://doi.org/10.1381/096089201321336584

    Article  PubMed  CAS  Google Scholar 

  7. Noun R, Skaff J, Riachi E, Daher R, Antoun N, Nasr M (2012) One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg 22:697–703

    Article  PubMed  Google Scholar 

  8. Lee WJ, Yu PJ, Wang W, Huang MT (2005) Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity. Ann Surg 242:20–28

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tacchino RM, Greco F, Matera D, Diflumeri G (2010) Single-incision laparoscopic gastric bypass for morbid obesity. Obes Surg 20:1154–1160

    Article  PubMed  Google Scholar 

  10. Bruzzi M, Rau C, Voron T, Guenzi M, Berqer A, Chevallier JM (2015) Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis 11:321–326

    Article  PubMed  Google Scholar 

  11. Fisher BL, Buchwald H, Clark W et al (2001) Mini-gastric bypass controversy. Obes Surg 11(6):773–777

    PubMed  CAS  Google Scholar 

  12. Lee WJ, Lin YH (2014) Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg 24:1749–1756

    Article  PubMed  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ser KH, Lee WJ, Lee YC, Chen JC, Su YH, Chen SC (2010) Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage. Surg Endosc 24(9):2253–2259

    Article  PubMed  Google Scholar 

  15. Pok EH, Lee WJ, Ser KH, Chen JC, Chen SC, Tsou JJ, Chin KF (2016) Laparoscopic sleeve gastrectomy in Asia: long term outcome and revisional surgery. Asian J Surg 39:21–28

    Article  PubMed  Google Scholar 

  16. Jammu G, Sharma R (2016) A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-en-Y gastric bypass and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg 26:926–932

    Article  PubMed  Google Scholar 

  17. Genser L, Carandina S, Tabbara M, Torcivia A, Soprani A, Siksik JM, Cady J (2016) Presentation and surgical management of leaks after mini-gastric bypass for morbid obesity. Surg Obes Relat Dis 12:305–312

    Article  PubMed  Google Scholar 

  18. Lee WJ, Ser KH, Lee YC, Tsou JJ, Chen SC, Chen JC (2012) Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg 27:623–631

    Google Scholar 

  19. Paroz A, Calmes JM, Giusti V, Suter M (2006) Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity: a continuous challenge in bariatric surgery. Obes Surg 16:1482–1487

    Article  PubMed  CAS  Google Scholar 

  20. Chowbey P, Baijal M, Kantharia N, Khullar R, Sharma A, Soni V (2016) Mesenteric defect closure decreases the incidence of internal hernias following laparoscopic Roux-en-Y gastric bypass: a retrospective cohort study. Obes Surg 26:2029–2034

    Article  PubMed  Google Scholar 

  21. Koner J, Inabnet W, Febres G, Conwell I, McMahon D, Salas R, Taveras C, Schrope B, Bessler M (2009) Prospective study of gut hormone and metabolic changes after adjustable gastric banding and Roux-en-Y gastric bypass. Int J Obes 33:786–793

    Article  CAS  Google Scholar 

  22. Lee WJ, Chen CY, Chong K, Lee YC, Chen SC, Lee SD (2011) Changes in postprandial gut hormones after metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy. Surg Obes Relat Dis 7:683–690

    Article  PubMed  Google Scholar 

  23. Venciauskas L, Johannes S, Emst A et al (2014) Short vs. long biliopancreatic limb gastric bypass for treatment of T2DM, randomized controlled study. Obes Surg 24:1149–1150

    Google Scholar 

  24. Caruana JA, Monte SV, Jacobs DM, Voytovich C, Ghanim H, Dandona P (2015) Distal small bowel bypass for weight regain after gastric bypass: safety and efficacy threshold occurs at < 70% bypass. Surg Obes Relat Dis 11:1248–1256

    Article  PubMed  Google Scholar 

  25. Miyachi T, Nagao M, Shikashi S, Kitahara Y, Tanaka N, Watanabe K, Tsuchiya T, Motoi F, Naitoh T, Unno M (2016) Biliopancreatic limb plays an important role in metabolic improvement after duodenal-jejunal bypass in a rat model of diabetes. Surgery 159(5):1360–1371

    Article  PubMed  Google Scholar 

  26. Flum DR, Dellinger P (2004) Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg 199:543–551

    Article  PubMed  Google Scholar 

  27. Lee WJ, Chong K, Ser KH, Lee YC, Chen SC, Chen JC, Tsai MH, Chung LM (2011) Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg 146(2):143–148

    Article  PubMed  Google Scholar 

  28. Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, Thomas S, Abood B, Nissen SE, Bhatt DL (2012) Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 366(17):1567–1576

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Min-Sheng General Hospital, No. 168, Chin Kuo Road, Tauoyan, Taiwan, ROC

    Nawaf Alkhalifah, Wei-Jei Lee, Tan Chun Hai, Kong-Han Ser, Jung-Chien Chen & Chun-Chi Wu

  2. Department of Surgery, Al-Adan General Hospital, Kuwait City, Kuwait

    Nawaf Alkhalifah

  3. Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore

    Tan Chun Hai

Authors
  1. Nawaf Alkhalifah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wei-Jei Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tan Chun Hai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kong-Han Ser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jung-Chien Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chun-Chi Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei-Jei Lee.

Ethics declarations

Disclosures

Dr. Narwaf Alkhalifah, Dr. Wei-Jei Lee, Dr. Tan Chun Hai, Dr. Kong-Han Ser, Dr. Jung-Chieh Chen, Dr. Chun-Chi Wu have no conflicts of interest or financial ties to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alkhalifah, N., Lee, WJ., Hai, T.C. et al. 15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures. Surg Endosc 32, 3024–3031 (2018). https://doi.org/10.1007/s00464-017-6011-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-017-6011-1

Keywords

Search

Navigation