Gastric bypass surgery is a better option than laparoscopic gastric banding

laproscopic surgery

During a recent study conducted in order to compare the results of different types of bariatric surgeries, laparoscopic Roux-en-Y gastric bypass (RYGB) was found to yield better results than the adjustable gastric banding (AGB) procedure. However, the risk of short term complications and subsequent hospitalizations was also greater with RYGB.

There has been a constant debate about the risks and benefits of both the bariatric surgeries. Studies done in the past have come up with conflicting results. There are admirers and critics of both RYGB and AGB in equal measures. To resolve this dispute, David Arterburn from the Group Health Research Institute, Seattle, along with his colleagues, carried out the present research, which has been published in the recent issue of the journal JAMA Surgery.

The researchers identified 7,457 patients from 10 health care systems in the United States, who had undergone bariatric surgeries between the period of 2005 and 2009. The patients were followed up for a period of one year and the reduction in their weights, short term complications of the surgeries and subsequent hospitalizations were compared. Major adverse outcomes like venous thromboembolism and death were also compared.

The researchers found that in patients who underwent AGB, the maximum reduction in BMI was 8.0. However, in patients who underwent RYGB, the maximum loss in BMI was 14.8. However, around 3% of the patients who had undergone RYGB experienced one or more major adverse outcome compared to 1.3% of patients who had undergone AGB. Amongst AGB patients, 0.2% died, 12.4% needed hospitalization whereas 13.7% needed subsequent intervention. Amongst RYGB patients, 0.3% died, 19.9% needed hospitalization whereas 5.5% needed subsequent intervention.

It is important to note that both RYGB and AGB carry a very low risk of perioperative events compared to other abdominal surgeries of similar complexity. Therefore, bariatric surgeries can be considered as safe procedures. But on comparing the two procedures, the researchers found that gastric bypass is two times more effective than AGB in the intermediate term. However, it carries a higher perioperative safety risk. It is important to explain the advantages and disadvantages of both the procedures to the patient undergoing bariatric surgery so that he can take an informed decision.

Reference:

·         http://archsurg.jamanetwork.com/article.aspx?articleid=1919066

Date: 
Thursday, November 20, 2014