Washington: Two new studies have found that gastric bypass surgery lead to better long-term results including greater weight loss, resolution of diabetes and improved quality of life compared with sleeve gastrectomy and "lap-band" surgery.
The most common surgical procedure for treating diabetes in the United States is the laparoscopic Roux-en-Y gastric bypass, more commonly referred to as gastric bypass surgery.
In 2001, the laparoscopic adjustable gastric band, also known as lap-band, was introduced as a less invasive alternative to gastric bypass.
Sleeve gastrectomy is another surgical weight-loss procedure, which involves surgical removal of a large portion of the stomach.
In the first study, Guilherme M. Campos, of the University of Wisconsin School of Medicine and Public Health and colleagues examined 100 morbidly obese patients who underwent lap-band surgery.
These patients were matched by sex, race, age and initial body mass index with 100 patients who underwent gastric bypass surgery.
All weight loss outcomes were significantly greater for patients who underwent gastric bypass. Average excess weight loss for this group was 64 percent, compared to 36 percent for lap-band patients.
Also resolution or improvement of type 2 diabetes was significantly better after gastric bypass compared to lap-band.
Early complications (within the first 30 days post-surgery) were higher in the gastric bypass group than the lap-band group.
However, the rate of re-operation was higher in lap-band patients compared to gastric bypass patients.
In a second report, Wei-Jei Lee, of the Min-Sheng General Hospital, Taiwan, and colleagues conducted a double-blind randomized controlled trial of 60 moderately obese patients between the ages of 30 and 60, who had poorly controlled type 2 diabetes after conventional treatment.
Between September 2007 and June 2008, half of the patients were randomized to undergo gastric bypass with duodenum exclusion and half were randomized to have a sleeve gastrectomy without duodenum exclusion.
Overall, 42 patients had remission of type 2 diabetes 12 months after surgery. However, this resolution was significantly greater for gastric bypass patients than sleeve gastrectomy patients.
Both groups also had significant weight loss at the one- and three-month post-surgery follow-up, but gastric bypass patients had better weight loss results at the six- and 12-month follow-ups.
The studies appeared in the February issue of Archives of Surgery, one of the JAMA/Archives journals.