Weight loss and complications of the banded Roux-en-Y gastric bypass: lessons learned from a prospective case control study

• Published in: Surgical endoscopy Vol. 36; no. 10; pp. 7516 - 7520
• Main Authors: Skidmore, Adam, Holt, Jonathon
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2022; Springer Nature B.V
• Subjects: Abdominal Surgery; Adolescent; Adult; Case-Control Studies; Endoscopy; Gastric Bypass - adverse effects; Gastric Bypass - methods; Gastroenterology; Gastrointestinal surgery; Gastroplasty - methods; Gynecology; Hepatology; Hernias; Humans; Laparoscopy; Laparoscopy - methods; Medicine; Medicine & Public Health; Obesity; Obesity, Morbid - surgery; Patients; Proctology; Reoperation; Retrospective Studies; Surgery; Treatment Outcome; Weight control; Weight Loss; Obesity; Gastric banding; Gastric bypass
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-022-09184-z

Objective
Obesity is a growing global health burden which is particularly challenging to manage. Bariatric surgery is considered the most effective means of sustained weight loss, and Roux-en-Y gastric bypass is considered the most effective treatment for morbid obesity. The additional benefit of placing a non-adjustable band to form a banded Roux-en-Y gastric bypass has gained interest as a measure to improve weight loss; however, comparative data are few, and complications can be high.
Methods
We conducted a prospective case–control study of 484 patients aged 18 and over who received either banded Roux-en-Y gastric bypass with a non-adjustable silastic ring or Roux-en-Y gastric bypass. Patients were followed up for five years and evaluated for weight loss, percentage excess weight loss (%EWL), BMI, and band-related complications.
Results
No significant difference was detected in %EWL or BMI between BRYGB and RYGB. The mean raw weight loss, %EWL, and BMI for BRYGB verse RYGB were as follows: 27.49 SD (17.11) kg verse 34.46 SD (18.18) kg, 65.7% SD (30%) verse 62.2% SD (37%), and 32.33 SD (6.9) kg/m
2
verse 32.43 SD (7.2) kg/m
2
. A total of 80 (21.7%) patients had the non-adjustable band removed for complications.
Conclusion
There is little difference in weight-loss results when comparing BRYGB to RYGB and non-adjustable bands may cause significant complications.