Banded vs. non-banded Roux-en-Y gastric bypass for morbid obesity: a systematic review and meta-analysis

Clin Obes. 2018 Dec;8(6):424-433. doi: 10.1111/cob.12274. Epub 2018 Aug 24.

Abstract

We aim to review the available literature on patients with morbid obesity treated with banded (BRYGB) or non-banded Roux-en-Y gastric bypass (NBRYGB), in order to compare the clinical outcomes and intraoperative parameters of the two methods. A systematic literature search was performed in PubMed, Cochrane library and Scopus databases, in accordance with the PRISMA guidelines. Eight studies met the inclusion criteria incorporating 3899 patients. This study reveals similar rates of complications, mortality, remission of type 2 diabetes, hypertension, dyslipidaemia, gastroesophageal reflux and obstructive sleep apnoea, along with similar % excess weight loss (%EWL) at 1 and 2 years postoperatively. In contrast, according to an analysis of two eligible studies the BRYGB procedure was associated with increased %EWL at 5 years postoperatively. These results should be interpreted with caution due to the small number of statistical arms and randomized controlled studies. However, the present article represents the best available evidence in the field. Well-designed, randomized controlled studies, comparing BRYGB to NBRYGB, are necessary to further assess their clinical outcomes.

Keywords: Roux-en-Y gastric bypass; banded gastric bypass; bariatric surgery; meta-analysis.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / therapy
  • Dyslipidemias / etiology
  • Dyslipidemias / therapy
  • Gastric Bypass / adverse effects
  • Gastric Bypass / methods*
  • Gastric Bypass / mortality
  • Gastroesophageal Reflux / etiology
  • Gastroesophageal Reflux / therapy
  • Humans
  • Hypertension / etiology
  • Hypertension / therapy
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology
  • Quality of Life
  • Sleep Apnea, Obstructive / etiology
  • Sleep Apnea, Obstructive / therapy
  • Treatment Outcome
  • Weight Loss