Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial
Abstract
Background There are few studies of long-term outcomes for either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to compare outcomes of patients randomly assigned to undergo LAGB or LRYGB at 10 years.Methods LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 ± 8.9 years; range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women; mean age 33.3 years; mean weight 120 kg; mean body mass index [BMI] 43.4 kg/m(2)) or LRYGB (n = 24, 4 men and 20 women; mean age 34.7; mean weight 120 kg; mean BMI 43.8 kg/m(2)). Data on complications, reoperations, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. The data were analyzed using Student's t test and Fisher's exact test, with P<.05 considered significant.Results Five patients in the LAGB group and 3 patients in the LRYGB group were lost to follow-up. No patient died. Conversion to laparotomy was performed in 1 (4.2%) of 24 LRYGB patients. Reoperations were required in 9 (40.9%) of 22 LAGB patients and in 6 (28.6%) of the 21 LRYGB patients. At 10-year follow-up, the LRYGB patients had a greater percentage of mean excess weight loss than did the LAGB patients (69±29% versus 46±27%; P = .03).Conclusion LRYGB was superior to LAGB in term of excess weight loss results (76.2% versus 46.2%) at 10 years. However, LRYGB exposes patients to higher early complication rates than LAGB (8.3% versus 0%) and potentially lethal long-term surgical complications (internal hernia and bowel obstruction rate: 4.7%).
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In four studies with follow-up of at least 5 years, port-related and band-related complications after adjustable gastric banding were documented for 18%, 23%, 27% and 43% of patients.
“Four studies with a follow-up of at least 5 years were identified. Port-related and band-related complications were documented for 18%, 23%, 27% and 43% of patients [78, 80, 85, 89].”
Re-interventions for insufficient weight loss after adjustable gastric banding were reported by 3 studies at follow-up >5 years and documented for 6%, 12% and 18% of patients.
“Re-interventions for insufficient weight loss were reported by 3 studies at follow-up > 5 years, and documented for 6%, 12% and 18% of patients [78, 80, 85].”
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Laparoscopic Adjustable Gastric Banding: Outcomes
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- Authors
- Angrisani, L., Cutolo, P. P., Formisano, G., Nosso, G., & Vitolo, G.
- Affiliations
- Federico II University Hospital (IT)
- Corresponding author
- Angrisani, Luigi
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 9
- Issue
- 3
- Pages
- 405-413
- ISSN
- 1550-7289 (ISSN-L)
- OpenAlex
- W2963595971
- Cited by
- 107
- References
- 39
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 7 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 9 · 2019: 3 · 2018: 15 · 2017: 12 · 2016: 10 · 2015: 13 · 2014: 9 · 2013: 5
- FWCI
- 12.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Surgery for Obesity and Related Diseases (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
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Complications, Prospective Studies, Reoperation, Gastric Bypass, Gastroplasty, Weight Loss, Body Mass Index, Young Adult
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