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Summary of Selected Presentations of ASMBS Meeting Part 3

Posted On : August 23, 2010

Laparoscopic Roux-En-Y Gastric Bypass Achieves Greater Weight Loss than Sleeve Gastrectomy after One Year

Surgery, Kaiser Permanente South Bay Medical Center, Harbor City, CA; Surgery, Harbor –UCLA Medical Center , Torrance, CA; Emergency Medicine, Harbor- UCLA Medical Center, Torrance , CA

Laparoscopic sleeve gastrectomy (LSG) has become very popular as a weight loss surgery. This study was conducted to portray similarities of LSG to ROUX-En-Y Gastric Bypass (RYGB) results. Patients who had the RYGB and LSG from 2007 to 2009 were analyzed for % excess weight loss (EWL), resolutions for co-morbidities, postoperative problems and mortality. Laparoscopic RYGB and LSG have comparable postoperative morbidity and mortality rates

Editorial: There is lots excitement about the sleeve gastrectomy. It is worthwhile to remember that as Duodenal surgeons, we have performed sleeve gastrectomy with every duodenal switch operation. At the beginning the sleeve gastrectomy was offered as a staging operation for hight risk Duodenal switch patients. The rationale was that by offering sleeve gastrectomy as a first part of the duodenal switch operation,a patient can loose some weight, and make the second part of the operation much less risky. It was with this observation then some surgeons started promoting sleeve gastrectomy as a primary operation. The long term data for sleeve gastrectomy is very limited. In my opinion, sleeve gastrectomy is a great alternative for some patient instead of the Lap Band®, since it does not involve placement of foreign body, and will not require adjustments. With all these information in mind, I would like to remind ourselves that all surgeries have their own drawbacks, and the only way a patient can make an informed educated decision is to know what their options are, and not be just told about one surgery.
Ara Keshishian, MD

  RYGB (n=345) Sleeve (n=192) P Value

Median Age

46 48 0.05

Median BMI kg/m2

47 43 <0.0001
Median length of hospital stay 3 3 1
DM - number and (%) of patient that had DM 112 (32%) 42 (22%) 0.01
Remission of DM 73 (65%) 31 (74%) 0.3
HTN - number and (%) of patient that had HTN 199 (58%) 102 (53%) 0.3
Resolution of HTN 95 (48%) 35 (34%) 0.003
GERD -number and (%) of patient that had GERD 83 (24%) 53 (28%) 0.4
Resolution of GERD 61 (73%) 18 (34%) < 0.0001
Median EWL at one month 9.7% 9.20% 0.05
Median EWL at 3 months 12.90% 16.20% <0.0001
Median EWL at 6 months 19.50% 22.50% < 0.0001
Median EWL at 12 months 28.90% 25.90% < 0.0001
Total complications 43 (12%) 21 (11%) 0.6
Mortality 1 (0.3%) 0.00% 1

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