Background and aims: 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.
Setting: The study was conducted at Centre Hospitalier Emil Mayrisch Clinic for specialized care (n = 618 beds) in Luxembourg (South).
Materials and methods: 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).
Results: 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).
Conclusion: The significant difference in %EBWL and BAROS and late adverse events with high re-operation rates in LAGB made the LRYGB more attractive.