Skip to main content
SpringerLink
Log in

Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass: A Single Center Experience with 2 Years Follow-Up

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Laparoscopic Sleeve Gastrectomy (LSG) is a relatively new procedure that is gaining wide acceptance. However, laparoscopic Roux-en-Y Gastric Bypass (LRYGB) remains one of the most commonly performed bariatric procedures with the best long-term results. There are few studies comparing LSG with LRYGB. The aim of this study is to compare the safety and outcome of LSG to LRYG in a single accredited center.

Methods

A retrospective analysis of data collected prospectively on patients undergoing either LSG or LRYGB between January 2009 and December 2012 was performed. LSG was performed using 36Fr bougie, while LRYGB was perfromed with a 25-mm circular stapler. The primary outcomes included length of stay (LOS), 30-day complication and readmission rates, and excess weight loss (%EWL) at 3, 6, 12, and 24 months postoperatively. LSG patients were also divided into different categories based on BMI and their %EWL compared to LRYGB.

Results

A total of 885 patients were included in our analysis. 547 patients underwent LRYGB (61.8 %) and 338 underwent LSG (38.2 %). Thirty-day complication and readmission rates for LRYGB and LSG were (1.5 and 5.1 % vs 0.6 and 0.3 %, respetively, p > 0.05). %EWL for LRYGB was significantly higher than LSG at 3, 6, 12, and 24 months. LSG with a BMI <40 achieved a similar %EWL to LRYGB in the first 12 months.

Conclusions

LSG seems to have a better safety profile in the short-term compared to LRYGB. However, at 2 years, LRYGB patients achieved a significantly higher EWL compared to LSG patients. Randomized clinical trials are needed to better elucidate our findings.

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

Similar content being viewed by others

References

  1. Albeladi B, Bourbao-Tournois C, Huten N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Baker M. Surgical clinics of North America. Bar Met Surg. 2011;91(6):1181–201.

    Google Scholar 

  3. Baltasar A et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15(8):1124–8.

    Article  PubMed  Google Scholar 

  4. Biertho L, Steffen R, Branson R, et al. Management of failed adjustable gastric banding. Surgery. 2005;137(1):33–41.

    Article  PubMed  Google Scholar 

  5. Buchwald et al. Baratric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  6. Buchwald H. The future of bariatric surgery. Obes Surg. 2004;15:598–605.

    Article  Google Scholar 

  7. Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240(3):416–23. discussion 423–4.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Dakwar A et al. Case report late complication of laparoscopic sleeve gastrectomy. Case Rep Gastrointest Med. 2013;2013:1–6.

    Article  Google Scholar 

  9. Daskalakis M, Weiner R. Sleeve Gastrectomy as a single-stage bariatric operation: indications and limitations. Obes Facts. 2009;2(1):8–10.

    Article  PubMed  Google Scholar 

  10. El Chaar M et al. Improving outcome of bariatric surgery: best practices in an accredited surgical center. Obes Surg. 2014.

  11. Flegal KM et al. Excess Deaths associated with underweight, overweight, and obesity. JAMA. 2005;292(15):1861–7.

    Article  Google Scholar 

  12. Franco JVA et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21(9):1458–68.

    Article  PubMed  Google Scholar 

  13. Guh DP et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Pub Health. 2009;9(1):88.

    Article  Google Scholar 

  14. Hady HR, Dadan J, Sołdatow M, et al. Complications after laparoscopic gastric banding in own material. Video Surg. 2012;7(3):166–74.

    Google Scholar 

  15. Helmiö M, Victorzon M, Ovaska J, et al. SLEEVEPASS: a randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results. Surg Endosc. 2012;26(9):2521–6.

    Article  PubMed  Google Scholar 

  16. Himpens J, Dapri G, Cadière GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.

    Article  PubMed  Google Scholar 

  17. Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254(3):410–20.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Karamanakos SN 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 

  19. Kehagias I et al. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obes Surg. 2011;21(11):1650–6.

    Article  PubMed  Google Scholar 

  20. Lakdawala MA et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20(1):1–6.

    Article  PubMed  Google Scholar 

  21. 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 

  22. Lim DM et al. Comparison of laparoscopic sleeve to laparoscopic roux-en-y gastric bypass for morbid obesity in a military institution. Obes Surg. 2012.

  23. Luján JA et al. Laparoscopic versus open gastric bypass in the treatment of morbid obesity. Ann Surg. 2004;239(4):433–7.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Maggard MA et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:557–9.

    Article  Google Scholar 

  25. Mann T et al. Medicare’s search for effective obesity treatments. Am Psych. 2007;63(3):220–3.

    Article  Google Scholar 

  26. Nguyen NT et al. Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–7.

    Article  PubMed  Google Scholar 

  27. Nguyen NT, Root J, Zainabadi K, et al. Accelerated growth of bariatric surgery with the introduction of minimally invasive surgery. Arch Surg. 2005;140(12):1198–202.

    Article  PubMed  Google Scholar 

  28. Obesity and overweight. World Health Organization website. www.who.int/mediacentra/factsheets/fs311/en. Accessed January 24, 2014.

  29. Overweight and obesity. Center for Disease Control and Prevention website. www.cdc.gov/obesity/resources/factsheets.html. Accessed January 22, 2014.

  30. Peterli R et al. Early results of the Swiss Multicenter Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258(5):690–4.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Sjöström L et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  32. Smith BR et al. Surgical approaches to the treatment of obesity: bariatric surgery. Med Clin N Am. 2011;95:1009–30.

    Article  PubMed  Google Scholar 

  33. Sturm R, Hattori A. Morbid obesity rates continue to rise rapidly in the United States. Int J Obes (Lond). 2013;37(6):889–91.

    Article  CAS  Google Scholar 

  34. Trastulli S, Desiderio J, Guarino S, et al. Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis. 2013;9(5):816–29.

    Article  PubMed  Google Scholar 

  35. Vidal P et al. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results. Obes Surg. 2012. doi:10.1007/s11695-012-0828-4.

    PubMed  Google Scholar 

  36. Wadden T et al. Efficacy of lifestyle modification for long-term weight control. Obes Res. 2012;12(S12):151S–62.

    Google Scholar 

  37. Wadden T et al. Treatment of obesity by very low calorie diet, behavior therapy, and their combination: a five-year prospective. Int J Obes. 1989;13(2):39–46.

    PubMed  Google Scholar 

Download references

Conflict of Interest

All authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Bariatric and Minimally Invasive Surgery, St Luke’s University Hospital and Health Network, Medical School of Temple University, 1736 Hamilton Boulevard, Allentown, PA, 18104, USA

    Maher El Chaar, Nadine Hammoud, George Ezeji, Leonardo Claros & Maureen Miletics

  2. Research Institute, St Luke’s Hospital University and Health Network, 801 Ostrum Street, Bethlehem, PA, 18105, USA

    Jill Stoltzfus

Authors
  1. Maher El Chaar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nadine Hammoud
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George Ezeji
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Leonardo Claros
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maureen Miletics
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jill Stoltzfus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maher El Chaar.

Additional information

This study was a retrospective study and therefore for this type of study formal consent was not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El Chaar, M., Hammoud, N., Ezeji, G. et al. Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass: A Single Center Experience with 2 Years Follow-Up. OBES SURG 25, 254–262 (2015). https://doi.org/10.1007/s11695-014-1388-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-014-1388-6

Keywords

Search

Navigation