Does Gastric Bypass Trump Banding? Study Says Yes
Although it does confer a higher rate of complications and early morbidity, Roux-en-Y gastric bypass surgery produces more rapid and sustained weight loss than gastric banding, according to a study published online in the Archives of Surgery.
In the new study, 442 patients were followed for about 6 years. Overall, weight loss was quicker, maximal weight loss was greater and weight loss remained “significantly better” among the 221 people in the gastric bypass arm when compared to participants who received gastric banding.
The risk for morbidity was higher after gastric bypass than gastric banding largely due to complications, 17.2% vs. 5.4%, respectively. There were more failures seen with gastric banding after 6 years including a body mass index greater than 35 and/or band reversal or conversion. There also were more long-term complications and more reoperations after gastric banding, the study showed.
Total cholesterol levels remained unchanged after gastric banding, but significantly decreased after gastric bypass. The initial lipid profile was similar among both groups, but the improvement after five years was “significantly better” after gastric bypass, the study showed.
“At the present time, [gastric bypass] seems clearly superior to gastric banding when treating morbidly obese patients, who should be informed accordingly,” conclude researchers who were led by Sebastien Romy, MD, of Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland.
Christine Ren Fielding, MD, the founder and director the New York University Langone Weight Management Program in New York City, says that the weight loss results were excellent for both bypass and banding in the new study. What’s more, banding tends to be provider-dependent, and this may have influenced the findings.
Specifically, “their weight loss outcomes and complications are all on par with the rest of the world, except for their high band erosion rate, which is over 7%,” she says. That is frighteningly high, and no other surgical practice or study in the US has this issue. If we did, I think we would perform less gastric bands,” she says.
“Delayed complications can happen with gastric banding, just like they can do with a car for example,” she says. “A part may need to be changed or repaired. Although these delayed complications from a band do require an operation, it is usually a straight-forward uncomplicated surgery. “
Source: Arch Surg. Published online. Jan. 16, 2012