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Cited by 115Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesBody Contouring and Surgery

Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States

Spivak, Hadar, Abdelmelek, Mena F., Beltran, Oscar R., Ng, Amelia W., Kitahama, Seiichi·2012·Surgical Endoscopy
DOI 10.1007/s00464-011-2125-z
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Abstract

Background Although laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are the most common bariatric procedures performed in the past decade, little is known about their long-term (>5 years) outcomes.Methods A retrospective outcome study investigated 148 consecutive patients from a single practice who underwent LAGB from November 2000 to March 2002. The group was matched with 175 consecutive patients who underwent LRYGB from June 2000 to March 2005. Follow-up data for 5 years or longer was available for 127 LAGB patients (86%) and 105 LRYGB patients (60%).Results After an initial 4 years of progressive weight loss, body mass index (BMI) loss stabilized at 5-7 years at approximately 15 kg/m(2) for the LRYGB patients and at about 9 kg/m(2) for the LAGB patients with band in place (P < 0.01). At 7 years, the excess weight loss (EWL) was 58.6% for LRYGB and 46.3% for LAGB with band in place (P < 0.01). By 7 years, 19 LAGB patients (15%) had had their bands removed, bringing the failure rate for LAGB (including patients with less than 25% EWL) to 48.3% versus 10.7% for LRYGB (P < 0.01). By 10 years, 29 (22.8%) of the bands had been removed, bringing the total LAGB failure rate to 51.1%. In 10 years, 67 LAGB (52.8%) and 43 LRYGB (41%) adverse events had occurred. However, over time, the LRYGB group experienced 9 (8.6%) serious, potentially life-threatening complications, whereas the LAGB group had none (P < 0.001). One procedure-related death occurred in the LRYGB group.Conclusions Over the long term, LRYGB had an approximate reduction of 15 kg/m(2) BMI and 60% EWL, a significantly better outcome than LAGB patients experienced with band intact. The main issue with LAGB was its 50% failure rate in the long term, as defined by poor weight loss and percentage of band removal. Nevertheless, LAGB had a remarkably safe course, and it may therefore be considered for motivated and informed patients.

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  • After RYGB, patients typically lose 35% of initial weight or 62-75% of excess body weight, significantly more than with gastric banding.

    “After RYGB, patients typically lose 35% of initial weight, or 62-75% of excess body weight47, 52-54, significantly greater than with GB.55, 56.”

    From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [56]

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Authors
Spivak, H., Abdelmelek, M. F., Beltran, O. R., Ng, A. W., & Kitahama, S.
Affiliations
Park Plaza Hospital (US)
Corresponding author
Spivak, Hadar
ORCID
Spivak, Hadar
Venue
Surgical Endoscopy
Publisher
Springer Science and Business Media LLC
Published
2012-01-05
Volume
26
Issue
7
Pages
1909-1919
ISSN
  • 0930-2794 (ISSN-L)
  • 1432-2218
DOI
10.1007/s00464-011-2125-z
OpenAlex
W2052858262
Cited by
115
References
39
Citations by year
2023: 3 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 15 · 2016: 9 · 2015: 14 · 2014: 18 · 2013: 26 · 2012: 8
FWCI
21.40
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Surgical Endoscopy (publishedVersion)
  • PubMed (publishedVersion)
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
laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass, bariatric surgery, long-term outcomes, excess weight loss, body mass index reduction, device failure, band removal, postoperative complications, morbid obesity, weight regain, procedure-related mortality, United States patients, United States health care costs, cost-effectiveness, quality of life, patient satisfaction
MeSH terms
Adult, Female, Humans, Intraoperative Complications, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Care, Postoperative Complications, Reoperation, Retrospective Studies, Texas, Gastric Bypass, Gastroplasty, Weight Loss, Body Mass Index, Treatment Outcome, Treatment Failure, Young Adult

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