A Retrospective 2-Year Follow-up of Late Complications Treated Surgically and Endoscopically After Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and Laparoscopic Sleeve Gastrectomy (LSG) for Morbid Obesity

Obes Surg. 2018 Apr;28(4):1055-1062. doi: 10.1007/s11695-017-2967-0.

Abstract

Background: The laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the gold standard for bariatric surgery, but recently, the laparoscopic sleeve gastrectomy (LSG) has gained popularity. At present, limited data is available on the long-term complications of these two types of surgery. The aim of this retrospective study was to compare the 2-year data about late (more than 30 days after surgery) complications that were treated surgically or endoscopically after LRYGB and LSG operations in a large hospital area with a single patient database.

Materials: This was a retrospective, non-randomized, single-center study of 760 (545 LRYGB and 215 LSG) bariatric patients surgically treated between 2008 and 2013 in the Bariatric Surgery Unit of Helsinki University Central Hospital.

Methods: The patients were followed for 2 years, and late complications (more than 30 days after surgery) that were surgically and/or endoscopically treated were registered. Weight loss and the risk factors for complications were also monitored.

Results: The study found a difference between the LRYGB and LSG patients in a number of late complications treated by both intervention types: surgical intervention were required in 9.4% of LRYGB patients vs. 0.9 of LSG patients, and endoscopic intervention were required by 4.6% of LRYGB patients vs. 1.4% of LSG patients (both p < 0.05). The risk of surgical complications was increased by better weight loss results in 12 months.

Conclusions: LRYGB was found to be associated with a greater risk of late complications. If larger databases confirm these results, the trend toward LSG is justified.

Keywords: Bariatric surgery; LRYGB; LSG; Late complications.

MeSH terms

  • Adult
  • Aged
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Gastric Bypass / adverse effects*
  • Gastric Bypass / methods
  • Humans
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / surgery*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult