Comparative study on laparoscopic sleeve gastrectomy and laparoscopic gastric bypass for treatment of morbid obesity patients.

Objective: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures for the treatment of morbid obesity. Laparoscopic sleeve gastrectomy (LSG) is a relatively innovative procedure which has been increasingly accepted as a sole bariatric procedure in the Asian-Pacific region. This study aims to compare mid-term outcomes in morbid obesity patients undergoing LRYGB and LSG.

Methods: Between January 2008 and May 2011, 94 morbid obesity patients were assigned by patient choice after informed consent to either a LSG (n = 56) or LRYGB (n = 38) group. We compared operation time, amount of bleeding, hospital length-of-stay, complications, improvement of diabetic patients, BMI, and excess weight loss (EWL) at 6-30 months post-operation.

Results: There was no death in either group. The operating time, hospital length-of-stay, and complications were significantly shorter in the LSG group (P < 0.05). There was no significant difference in the overall improvement of diabetes mellitus (P > 0.05). LRYGB had better effectiveness than LSG in BMI decrease and EWL in the first year (P < 0.05), but there was no significant difference after 1 year (P > 0.05).

Conclusions: The two procedures are safe and effective, but the LRYGB procedure incurs a high number of complications and long hospital stay. LSG is a promising bariatric procedure and the results of LSG as a single procedure are equally effective to LRYGB at 2 years follow-up on weight reduction. Furthermore, the LSG group has a more stable EWL in the early stage. However, studies with large number of patients and longer follow-up are necessary to make a definitive conclusions.