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Cited by 255Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesBody Contouring and Surgery

A Prospective Randomized Trial of Laparoscopic Gastric Bypass Versus Laparoscopic Adjustable Gastric Banding for the Treatment of Morbid Obesity: Outcomes, Quality of Life, and Costs

Nguyen, Ninh T., Slone, Johnathan A., Nguyen, Xuan-Mai T., Hartman, Jaimee S., Hoyt, David B.·2009·Annals of Surgery
DOI 10.1097/sla.0b013e3181b92480
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Abstract

BACKGROUND: Gastric bypass and adjustable gastric banding are the 2 most commonly performed bariatric procedures for the treatment of morbid obesity. The aim of this study was to compare the outcomes, quality of life, and costs of laparoscopic gastric bypass versus laparoscopic gastric banding. STUDY DESIGN: Between 2002 and 2007, 250 patients with a body mass index of 35 to 60 kg/m2 were randomly assigned to gastric bypass or gastric banding. After exclusion, 111 patients underwent gastric bypass and 86 patients underwent gastric banding. Outcome measures included demographic data, operative time, blood loss, length of hospital stay, morbidity, mortality, early and late reoperation rate, weight loss, changes in quality of life, and cost. Treatment failure was defined as losing less than 20% of excess weight or conversion to another bariatric operation for failure of weight loss. RESULTS: There were no deaths at 90 days in either group. The mean body mass index was higher in the gastric bypass group (47.5 vs. 45.5 kg/m2, respectively, P < 0.01) while the mean age was higher in the gastric band group (45 vs. 41 years, respectively, P < 0.01). Compared with gastric banding, operative blood loss was higher and the mean operative time and length of stay were longer in the gastric bypass group. The 30-day complication rate was higher after gastric bypass (21.6% vs. 7.0% for gastric band); however, there were no life-threatening complications such as leaks or sepsis. The most frequent late complication in the gastric bypass group was stricture (14.3%). The 1-year mortality was 0.9% for the gastric bypass group and 0% for the gastric band group. The percent of excess weight loss at 4 years was higher in the gastric bypass group (68 ± 19% vs. 45 ± 28%, respectively, P < 0.05). Treatment failure occurred in 16.7% of the patients who underwent gastric banding and in 0% of those who underwent gastric bypass, with male gender being a predictive factor for poor weight loss after gastric banding. At 1-year postsurgery, quality of life improved in both groups to that of US norms. The total cost was higher for gastric bypass as compared with gastric banding procedure ($12,310 vs. $10,766, respectively, P < 0.01). CONCLUSIONS: Laparoscopic gastric bypass and gastric banding are both safe and effective approaches for the treatment of morbid obesity. Gastric bypass resulted in better weight loss at medium- and long-term follow-up but was associated with more perioperative and late complications and a higher 30-day readmission rate. There was a wide variation in weight loss after gastric banding with a small proportion of patients considered as treatment failure, and male gender was a predictive factor for poor weight loss.

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Crossref · 10.1097/sla.0b013e3181b92480

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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 [55]

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Authors
Nguyen, N. T., Slone, J. A., Nguyen, X.-M. T., Hartman, J. S., & Hoyt, D. B.
Affiliations
University of California, Irvine Medical Center (US)
ORCID
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-10
Volume
250
Issue
4
Pages
631-641
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/sla.0b013e3181b92480
OpenAlex
W2077899488
Cited by
255
References
23
Citations by year
2025: 3 · 2024: 8 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 8 · 2017: 16 · 2016: 18 · 2015: 21 · 2014: 34 · 2013: 32 · 2012: 38
FWCI
29.35
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Surgery (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 gastric bypass, laparoscopic adjustable gastric banding, morbid obesity, bariatric surgery, weight loss, quality of life, postoperative complications, gastric stricture, treatment failure, cost comparison, excess weight loss, operative time, length of hospital stay, mortality
MeSH terms
Adolescent, Adult, Female, Humans, Length of Stay, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Complications, Prospective Studies, Quality of Life, Risk Factors, Sex Factors, Time Factors, Gastric Bypass, Gastroplasty, Weight Loss, Chi-Square Distribution, Blood Loss, Surgical, Treatment Outcome, Patient Satisfaction

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