Sleeve Gastrectomy Or Gastric Bypass as Primary Bariatric Procedure: Retrospective Evaluation of Outcomes.

Mousa Khoursheed, MD, FRCS, Ibtisam Al-Bader, MD, FRCS, Ali Mouzannar, BMBCH, Abdulla Al-Haddad, MD, FACS, Ali Sayed, MD, FRCS, Ali Mohammad, MD, FRCS, Abe Finferhut, MD, FACS. Department of surgery, faculty of medicine, Kuwait university.

Roux-en-Y gastric bypass (RYGB) is a gold standard bariatric procedure and sleeve gastrectomy (SG) is innovative procedure that is increasingly applied as a stand-alone procedure. Our objective was to determine whether significant differences exist in outcomes between primary RYGB and SG

METHODS AND PROCEDURES Patients who underwent laparoscopic SG and RYGB were retrospectively compared and analyzed. Data included demographics, operative time, hospital stay, conversion rate, percentage excess weight loss (%EWL), morbidity and mortality.

RESULTS Fifty SG and 50 RYGB were performed. The median preoperative weight (117.2, 112.2 Kg, p=0.3) and BMI (40.0 versus 42.4 Kg/m2, p=0.7) were not significantly different respectively. The mean operative time was significantly shorter in SG (92.4 versus 110.5 minutes, p<0.005) and the median hospital (2 versus 2 days, p=0.2) was not significantly different respectively. There was no conversion in neither group. The reoperation rate in RYGB was 2%, however, it was not statistically different (0.0% versus 2%, p=0.2). The overall complication rates were not statistically different (4.0%% versus 4.0%, P=0.6). The mean follow up was (20.1 versus 17.8 months, P=0.3) respectively. The mean postoperative BMI at 1 year was (32.2 versus 29.2 Kg/m2, p= 0.09) and the mean %EWL was (55.7% versus 65.7%, p=0.1) respectively.

CONCLUSION(S) Both SG and RYGB are safe procedures with similar outcomes in terms of %EWL. Due to the complexity of RYGB, SG may be a better option in this group of patients. Further confirmation and longer follow up is needed.

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