Complications and outcome after laparoscopic bariatric surgery: LAGB versus LRYGB

作者：Zuegel Nikolaus P; Lang Reinhold A^*; Huettl Thomas P; Gleis Marc; Ketfi Jungen Marguerite; Rasquin Isabelle; Kox Martin

来源：Langenbeck's Archives of Surgery, 2012, 397(8): 1235-1241.

DOI：10.1007/s00423-012-0945-5

• Obesity surgery
• Gastric bypass
• Gastric banding
• Outcome

Unsatisfactory patient compliance and unfavorable results of weight loss let centers prefer the Roux-en-Y gastric bypass (RYGB) as a combined restrictive and malabsorptive procedure. The aim of this study was to evaluate results of laparoscopic adjustable gastric banding (LAGB) versus laparoscopic RYGB.
The study was conducted at Centre Hospitalier Emil Mayrisch Clinic for specialized care (n = 618 beds) in Luxembourg (South).
Of 620 procedures, 204 patients had LAGB and 416 LRYGB. Short-term (t (1), 6 months to 2 years), middle-term (t(2), 2 to 5 years), and long-term follow-up (t (3), > 5 years) were performed, including weight loss evolution, Bariatric Analysis, and Reporting Outcome System (BAROS).
Percent EBWL mean values for LAGB vs. LRYGB were at t (1) 64.3 vs. 79.5, p = 0.01; at t (2) 49.4 vs. 91, p < 0.0001; and at t(3) 52.6 vs. 79.9, p < 0.0001. The BAROS mean values were at t (1) 3.81 vs. 4.00, p = 0.183; at t (2) 3.57 vs. 4.12, p < 0.001; and at t (3) 3.71 vs. 4.04, p = 0.02. Major complication rate (< 30 days) was similar (p = 0.601). Long-term (> 30 days) complications were more common after LAGB (14.3 versus 3.6 %, p < 0.001). Fifty patients (25 %) required a second and 36 patients (18 %) a third operation (LRYGB).
The significant difference in %EBWL and BAROS and late adverse events with high re-operation rates in LAGB made the LRYGB more attractive.

• 出版日期2012-12