Outcomes of Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding

Table 1 Characteristics of patients with Roux-en-Y gastric bypass and laparoscopic adjustable gastric band n (%)

	RYGB (n = 609)	LAGB (n = 686)
Gender (M:F)	116: 493	131: 555
Age (yr)	42.4 ± 10.5b	37.2 ± 9.4
Initial BMI (kg/m2)	46.8 ± 7.1b	40.4 ± 4.2
Co-morbidities (sub-group analysis)	(n = 301)	(n = 545)
Total co-morbidities	216 (71.0)	363 (66.6)
Type 2 diabetes mellitus (n)	82	95
Hypertension (n)	51	157
Hyperlipidemia (n)	116	117
Obstructive sleep apnoea (n)	97b	113
Duration of follow-Median (yr)	2.0 (1.0-5.0)	1.6 (1.0-2.2)

^bP < 0.01 vs LAGB. BMI: Body mass index; RYGB: Roux-en-Y gastric bypass; LAGB: Laparoscopic adjustable gastric band; M: Male; F: Female.

Table 2 Acute- and long-term complications between Roux-en-Y gastric bypass and laparoscopic adjustable gastric band

RYGB (n= 609)	LAGB (n= 686)
Acute complications (n)
n = 49 (8.0%)	n = 3 (0.5%) (P < 0.0001 vs RYGB)
Wound infection (35)	Small leak, required band removal after 1 d (1)
Abdominal sepsis (3)	Post-op respiratory infection (1)
Splenic trauma (2)	Large wound haematoma, drained spontaneously (1)
DVT and PE (2)
Endoscopy for stomal obstruction (4)
Mechanical failure (3)
Long-term complications (n)
n = 13 (2.1%)	n = 61 (8.9%) (P < 0.0001 vs RYGB)
Reversal of RYGB (n = 1)	Removed and replaced LB (19)
Incisional hernia (n = 7)	Replacement of port (16)
Bowel obstruction (n = 5)	Removed LB (13)
	Converted to RYGB (7)
	Stomal obstruction required dilation (3)
	Mechanical failure (3)

RYGB: Roux-en-Y gastric bypass; LAGB: Laparoscopic adjustable gastric band; LB: Lap-band.

Table 3 Characteristics of patients with and without biochemical data

	RYGB (n = 609)			LAGB (n = 686)
	Biochemical data (n = 301)	No biochemical data (n = 308)	P-value	Biochemical data (n = 545)	No biochemical data (n = 141)	P-value
Gender (M:F)	63:238	53:255	> 0.05	101:444	30:111	> 0.05
Age (yr)	42.9 ± 10.2	42.0 ± 10.6	> 0.05	37.8 ± 9.4	37.1 ± 9.5	> 0.05
Initial BMI (kg/m2)	45.9 ± 7.5	47.0 ± 7.4	> 0.05	40.6 ± 4.1	40.3 ± 4.2	> 0.05
BMI reduction at 12 mo (kg/m2)	-6.5 ± 3.4	-7.7 ± 4.6	> 0.05	-1.2 ± 0.8	-1.4 ± 0.9	> 0.05
BMI reduction at 3 yr (kg/m2)	-18.2 ± 3.9	-19.0 ± 4.9	> 0.05	-4.9 ± 2.6	4.3 ± 2.4	> 0.05

BMI: Body mass index; RYGB: Roux-en-Y gastric bypass; LAGB: Laparoscopic adjustable gastric band; M: Male; F: Female.

Table 4 Co-morbidities before and 12 mo after Roux-en-Y gastric bypass and laparoscopic adjustable gastric band n (%)

	RYGB	LAGB	P-value
	(n = 301)	(n = 554)	(RYGB vs LAGB)
Diabetes mellitus
Pre-operative	83 (28)	127 (23)	0.34
Normalization of fasting blood glucose1	26 (33)	22 (17)	0.02
Hyper-cholesterolemia
Pre-operative	125 (42)	224 (41)	0.77
Normalization of total plasma cholesterol1	65 (52)	9 (4)	< 0.001
Hyper-triglyceridemia
Pre-operative	63 (21)	124 (22)	0.86
Normalization of plasma triglyceride1	51 (81)	34 (27)	< 0.0001
Obstructive sleep apnoea
Pre-operative	100 (33)	130 (23)	0.02
No longer required CPAP at 12 mo	10 (10)	4 (3)	0.04

¹Compared to pre-operative. RYGB: Roux-en-Y gastric bypass; LAGB: Laparoscopic adjustable gastric band; CPAP: Continuous positive airway pressure.

Table 5 Fasting blood glucose and lipid profile after Roux-en-Y gastric bypass and laparoscopic adjustable gastric band

	RYGB	LAGB	P-value
	(n = 301)	(n = 554)	(RYGB vs LAGB)
Fasting blood sugar
Prior to surgery	5.9 ± 1.6	5.7 ± 1.7	0.12
6-month post-op	5.3 ± 1.6b	5.5 ± 1.9b	0.57
12-month post-op	5.0 ± 1.7b	5.4 ± 1.6b	0.02
Total cholesterol
Prior to surgery	5.2 ± 1.0	5.2 ± 1.0	0.65
6-month post-op	4.2 ± 0.9b	5.2 ± 1.0	< 0.0001
12-month post-op	4.3 ± 0.9b	5.0 ± 1.0b	< 0.0001
Total triglyceride
Prior to surgery	1.7 ± 0.5	2.0 ± 0.6	0.44
6-month post-op	1.2 ± 0.6b	1.5 ± 0.6	0.01
12-month post-op	1.1+0.4b	1.5 ± 0.5	0.04
HDL
Prior to surgery	1.3 ± 0.3	1.3 ± 0.3	0.26
6-month post-op	1.3 ± 0.3	1.4 ± 0.3b	0.21
12-month post-op	1.4 ± 0.3b	1.5 ± 0.3b	0.56

^bP < 0.01 vs baseline. RYGB: Roux-en-Y gastric bypass; LAGB: Laparoscopic adjustable gastric band; HDL: High-density lipoprotein; op: Operative.