Skip to main content

Advertisement

SpringerLink
Log in

A Meta-analysis: To Compare the Clinical Results Between Gastric Bypass and Sleeve Gastrectomy for the Obese Patients

  • Review
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

We attempted to compare the effects of two kinds of surgery for obesity: laparoscopic gastric bypass (LGB) and laparoscopic sleeve gastrectomy (LSG). We performed an electronic literature search of published articles relating to obesity surgery since inception to July 2012, in which LGB was compared with LSG for patients with a body mass index (BMI) >30, and eight studies were finally selected. We recorded a benefit of LGB on the change of BMI (OR = 1.84, 95 % CI = 0.50–3.18). Besides, we found that the homeostasis model assessment was lower after LGB than LSG (OR = −0.83, 95 % CI = −1.43 to −0.22), the total cholesterol was also lower (OR = −17.43, 95 % CI = −34.72 to −0.14), and the high-density lipoprotein cholesterol was higher in the LGB group (OR = 3.27, 95 % CI = 0.48–6.06). Based on these findings, LGB could have a better effect compared with LSG.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. O’Brien PE. Bariatric surgery: mechanisms, indications and outcomes. J Gastroenterol Hepatol. 2010;25(8):1358–65.

    Article  PubMed  Google Scholar 

  2. NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.

    Google Scholar 

  3. Brolin RE. Gastric bypass. Surg Clin N Am. 2001;81(5):1077–95.

    Article  PubMed  CAS  Google Scholar 

  4. Fisher BL, Barber AE. Gastric bypass procedures. Eur J Gastroenterol Hepatol. 1999;11:93–7.

    Google Scholar 

  5. Smith BR, Schauer P, Nguyen NT. Surgical approaches to the treatment of obesity: bariatric surgery. Med Clin North Am. 2011;95(5):1009–30.

    Article  PubMed  Google Scholar 

  6. Leyba JL, Aulestia SN, Llopis SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg. 2011;21(2):212–6.

    Article  PubMed  Google Scholar 

  7. Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37(4):275–81.

    Article  PubMed  Google Scholar 

  8. Gluck B, Movitz B, Jansma S, et al. Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure for the lower BMI (35.0–43.0 kg/m2) population. Obes Surg. 2011;21(8):1168–71.

    Article  PubMed  Google Scholar 

  9. Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.

    Article  PubMed  CAS  Google Scholar 

  10. LÜ M, Deng J, Cao Y, et al. Prognostic role of telomerase activity in gastric adenocarcinoma: a meta-analysis. Exp Ther Med. 2012;3:728–34.

    PubMed  Google Scholar 

  11. Stang A. Critical evaluation of the Newcastle–Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.

    Article  PubMed  Google Scholar 

  12. Athanasiou T, Al-Ruzzeh S, Kumar P, et al. Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Ann Thorac Surg. 2004;77(2):745–53.

    Article  PubMed  Google Scholar 

  13. Lee WJ, Chen CY, Chong K, et al. Changes in postprandial gut hormones after metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(6):683–90.

    Article  PubMed  Google Scholar 

  14. Roslin MS, Dudiy Y, Weiskopf J, et al. Comparison between RYGB, DS and VSG effect on glucose homeostasis. Obes Surg. 2012;22(8):1281–6.

    Article  PubMed  Google Scholar 

  15. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.

    Article  PubMed  CAS  Google Scholar 

  16. Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250(2):234–41.

    Article  PubMed  Google Scholar 

  17. Iannelli A, Anty R, Schneck AS, et al. Inflammation, insulin resistance, lipid disturbances, anthropometrics, and metabolic syndrome in morbidly obese patients: a case control study comparing laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Surgery. 2011;149(3):364–70.

    Article  PubMed  Google Scholar 

  18. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8.

    Article  PubMed  Google Scholar 

  19. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.

    Article  PubMed  Google Scholar 

  20. Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–8.

    Article  PubMed  Google Scholar 

  21. Lau DC, Douketis JD, Morrison KM, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176(8):S1–13.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14:1157–64.

    Article  PubMed  Google Scholar 

  24. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:41.

    Google Scholar 

  25. Gastrointestinal surgery for severe obesity: National Institutes Of Health Consensus Conference Statement. Am J Clin Nutr 1992; 55:615–619.

  26. Keidar A. Bariatric surgery for type 2 diabetes reversal: the risks. Diabetes Care. 2011;34:S361–6.

    Article  PubMed  Google Scholar 

  27. Li Q, Chen L, Yang Z, et al. Metabolic effects of bariatric surgery in type 2 diabetic patients with body mass index < 35 kg/m2. Diabetes Obes Metab. 2012;14(3):262–70.

    Article  PubMed  CAS  Google Scholar 

  28. Padwal R, Klarenbach S, Wiebe N, et al. Bariatric surgery: a systematic review and network meta-analysis of randomized trials. Obes Rev. 2011;12(8):602–21.

    Article  PubMed  CAS  Google Scholar 

  29. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.

    Article  PubMed  Google Scholar 

  30. Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. 2004;135(3):326–51.

    Article  PubMed  Google Scholar 

  31. Leyba JL, Aulestia SN, Llopis SN. A prospective study of 117 patients. Obes Surg. 2011;21(2):212–6.

    Article  PubMed  Google Scholar 

  32. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.

    Article  PubMed  CAS  Google Scholar 

  33. Inaba M, Okuno S, Kumeda Y, et al. Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol. 2007;18(3):896–903.

    Article  PubMed  CAS  Google Scholar 

  34. Bloomberg RD, Fleishman A, Nalle JE, et al. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145–54.

    Article  PubMed  Google Scholar 

  35. Lynch RJ, Eisenberg D, Bell RL. Metabolic consequences of bariatric surgery. J Clin Gastroenterol. 2006;40(8):659–68.

    Article  PubMed  Google Scholar 

  36. Topart P, Becouarn G, Ritz P. Comparative early outcomes of three laparoscopic bariatric procedures: sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis. 2012;8(3):250–4.

    Article  PubMed  Google Scholar 

  37. Sterne JAC, Egger M, Moher D. Chapter 10: addressing reporting biases. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions, version 5.0.1 [updated September 2008]. The Cochrane Collaboration; 2008.

Download references

Conflict of Interest

We declare that we have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China

    Xuechao Yang, Guang Yang, Wensheng Wang, Guoqing Chen & Hua Yang

Authors
  1. Xuechao Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guang Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wensheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guoqing Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hua Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hua Yang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yang, X., Yang, G., Wang, W. et al. A Meta-analysis: To Compare the Clinical Results Between Gastric Bypass and Sleeve Gastrectomy for the Obese Patients. OBES SURG 23, 1001–1010 (2013). https://doi.org/10.1007/s11695-013-0938-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-013-0938-7

Keywords

Search

Navigation