Evaluation of the effects of laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy on weight loss

Abstract

Objectives: Obesity has become one of the most serious and ever increasing health problems of our times. Diet, exercise and medical treatment have proven to be insufficient. Operations such as laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) have gained popularity. The purpose of this study is to conduct a retrospective comparative analysis of the clinical results gained from patients treated with LSG and LAGB due to morbid obesity.

Methods: The patients included in the study were selected among those who were diagnosed with morbid obesity and were operated with LAGB (n = 55) and LSG (n = 52) from May 2007 to December 2012. Both groups were compared in terms of the demographic characteristics, preoperative and postoperative conditions.

Results: The groups were similar in terms of age, sex and BMI. In the 6^th month, there was a notable loss of appetite in the LSG group patients compared to the LAGB patients (69.2% vs. 23.6%, p < 0.001). The rate of excess weight loss in the LAGB group was 23.93% ± 7.98% and 31.7% ± 7.49% in the LSG group in the postoperative 6^th months (p = 0.002). The rate of excess weight loss was 45.36% ± 10.92% in the LAGB group and 60.3% ± 9.81% in the LSG group in the postoperative 12^th months (p ˂ 0.001).

Conclusions: When the two surgical operations for morbid obesity are compared LSG is found to be a more successful method in terms of body weight loss. Nevertheless, longer hospitalization can be associated with the technically more complicated nature of the operation and the fact that it requires resection. 

Keywords

• Obesity,bariatric surgery,sleeve gastrectomy,laparoscopic adjustable gastric banding

References

1. 1. Shi X, Karmali S, Sharma AM, Birch DW. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 2010;20:1171-7.
2. 2. Padwal RS, Pajewski NM, Allison DB, Sharma AM. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ 2011;183:E1059-66.
3. 3. Li Z, Bowerman S, Heber D. Health ramifications of the obesity epidemic. Surg Clin North Am 2005;85:681-701.
4. 4. Samuel I, Mason EE, Renquist KE, Huang YH, Zimmerman MB, Jamal M. Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry. Am J Surg 2006;192:657-62.
5. 5. Varela JE. Laparoscopic sleeve gastrectomy versus laparoscopic adjustable gastric banding for the treatment severe obesity in high risk patients. JSLS 2011;15:486-91.
6. 6. Chapman AE, Kiroff G, Game P, Foster B, O'Brien P, Ham J, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326-51.
7. 7. Boza C, Gamboa C, Perez G, Crovari F, Escalona A, Pimentel F, et al. Laparoscopic adjustable gastric banding LAGB: surgical results and 5-year follow-up. Surg Endosc 2011;25:292-7.
8. 8. Hii MW, Lake AC, Kenfield C, Hopkins GH. Laparoscopic conversion of failed gastric banding to Roux-en-Y gastric bypass. Short-term Follow-up and technical considerations. Obes Surg 2012;22:1022-8.

9. 9. Suter M, Calmes JM, Paroz A, Giusti V. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 2006;16:829-35.
10. 10. Chevallier JM, Zinzindohoue F, Douard R, Blanche JP, Berta JL, Altman JJ, et al. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg 2004;14:407-14.
11. 11. Langer FB, Bohdjalian A, Shakeri-Manesch S, Felberbauer FX, Ludvik B, Zacherl J, et al. Inadequate weight loss vs secondary weight regain: laparoscopic conversion from gastric banding to Roux-en-Y gastric bypass. Obes Surg 2008;18:1381-6.
12. 12. Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy. Obes Surg 2008;18:487-96.
13. 13. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 2006;16:1450-6.
14. 14. Burton PR, Brown WA. The mechanism of weight loss with laparoscopic adjustable gastric banding: induction of satiety not restriction. Int J Obes (Lond) 2011;35 Suppl 3:S26-30.
15. 15. Yehoshua RT, Eidelman LA, Stein M, Fichman S, Mazor A, Chen J, et al. Laparoscopic sleeve gastrectomy--volume and pressure assessment. Obes Surg 2008;18:1083-8.
16. 16. Melissas J, Koukouraki S, Askoxylakis J, Askoxylakis I, Metaxari M, Dimitriadis E, et al. Sleeve gastrectomy - a “food limiting” operation. Obes Surg 2008;18:1251-6.
17. 17. Gagner M. Faster gastric emptying after laparoscopic sleeve gastrectomy. Obes Surg 2010;20:964-5.
18. 18. Ashrafian H, le Roux CW. Metabolic surgery and gut hormones - a review of bariatric entero-humoral modulation. Physiol Behav 2009;97:620-31.
19. 19. Anderson B, Switzer NJ, Almamar A, Shi X, Birch DW, Karmali S. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg 2013;23:1476-80.
20. 20. Tolonen P, Victorzon M, Makela J. 11-year experience with laparoscopic adjustable gastric banding for morbid obesity - what happened to the first 123 patients? Obes Surg 2008;18:251-5.
21. 21. Ren CJ, Weiner M, Allen JW. Favorable early results of gastric banding for morbid obesity: the American experience. Surg Endosc 2004;18:543-6.
22. 22. O’Brien PE, Dixon JB, Brown W, Schachter LM, Chapman L, Burn AJ, et al. The laparoscopic adjustable gastric band (Lap-Band): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg 2002;12:652-60.
23. 23. Lanthaler M, Strasser S, Aigner F, Margreiter R, Nehoda H. Weight loss and quality of life after gastric band removal or deflation. Obes Surg 2009;19:1401-8.
24. 24. Dargent J. Isolated food intolerance after adjustable gastric banding: a major cause of long-term band removal. Obesity Surg 2008;18:829-32.
25. 25. Martin LF, Smits GJ, Greenstein RJ. Treating morbid obesity with laparoscopic adjustable gastric banding. Am J Surg 2007;194:333-43.
26. 26. Mittermair RP, Obermüller S, Perathoner A, Sieb M, Aigner F, Margreiter R. Results and complications after Swedish adjustable gastric banding-10 years’ experience. Obes Surg 2009;19:1636-41.
27. 27. Khan OA, Mansour S, Irukulla S, Reddy KM, Vasilikostas G, Wan AC. Sleeve gastrectomy for gastric band failures - a prospective study. Int J Surg 2013;11:407-9.
28. 28. Chakravarty PD, McLaughlin E, Whittaker D, Byrne E, Cowan E, Xu K, et al. Comparison of laparoscopic adjustable gastric banding (LAGB) with other bariatric procedures; a systematic review of the randomized controlled trials. Surgeon 2012;10:172-82.