Roux-en-Y Gastric Bypass vs Gastric Banding for Morbid Obesity: A Case-Matched Study of 442 Patients
Abstract
HYPOTHESIS: Gastric banding (GB) and Roux-en-Y gastric bypass (RYGBP) are used in the treatment of morbidly obese patients. We hypothesized that RYGBP provides superior results. DESIGN: Matched-pair study in patients with a body mass index (BMI) less than 50. SETTING: University hospital and regional community hospital with a common bariatric surgeon. PATIENTS: Four hundred forty-two patients were matched according to sex, age, and BMI. INTERVENTIONS: Laparoscopic GB or RYGBP. MAIN OUTCOME MEASURES: Operative morbidity, weight loss, residual BMI, quality of life, food tolerance, lipid profile, and long-term morbidity. RESULTS: Follow-up was 92.3% at the end of the study period (6 years postoperatively). Early morbidity was higher after RYGBP than after GB (17.2% vs 5.4%; P<.001), but major morbidity was similar. Weight loss was quicker, maximal weight loss was greater, and weight loss remained significantly better after RYGBP until the sixth postoperative year. At 6 years, there were more failures (BMI>35 or reversal of the procedure/conversion) after GB (48.3% vs 12.3%; P<.001). There were more long-term complications (41.6% vs 19%; P.001) and more reoperations (26.7% vs 12.7%; P<.001) after GB. Comorbidities improved more after RYGBP. CONCLUSIONS: Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than GB, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after GB.
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Estimates of hip bone loss after gastric banding vary from no change at 1 year to 6% at 24 months.
“Estimates of hip bone loss have been variable, from no change at 1 year in study of only premenopausal women, to 6% at 24 months40, 41.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [41]
After gastric banding, vitamin D remains stable or increases and PTH remains stable.
“post-operatively vitamin D remains stable or increases and PTH remains stable40, 41.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [41]
After gastric banding, lumbar spine BMD does not change or increases slightly.
“Studies have reported that LS BMD does not change, or increases slightly 40, 41, 43, 44.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [41]
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- Authors
- Romy, S., Donadini, A., Giusti, V., & Suter, M.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Suter, Michel
- ORCID
- Suter, Michel
- Venue
- Archives of Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2012-05-01
- Volume
- 147
- Issue
- 5
- Pages
- 460-6
- ISSN
- 0004-0010 (ISSN-L)
- OpenAlex
- W2136688075
- Cited by
- 45
- References
- 50
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 1 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 6 · 2013: 13 · 2012: 6
- FWCI
- 9.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Surgery (publishedVersion)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- Roux-en-Y gastric bypass, gastric banding, morbid obesity, bariatric surgery, weight loss, postoperative complications, reoperation, obesity-related comorbidities, quality of life, food tolerance, long-term outcomes
- MeSH terms
- Humans, Obesity, Morbid, Gastric Bypass, Gastroplasty
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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