Comparative Study Between Mini-Gastric Bypass and Roux-En-Y Gastric Bypass in Asian Population

Ajay H Bhandarwar, MS, Chintan B Patel, ms, Saurabh S Gandhi, MS, Amol N Wagh, MS, Eham L Arora, Priyank D Kothari. Grant medical college Mumbai

Introduction: Asian population have increased risk of type 2 diabetes ,hypertension and dyslipidemia at lower BMI compared to western populations. This has been attributed to genetic factors. Laparoscopic minigastric bypass is a single anastomosis procedure with a shorter learning curve .We present a comparative study between LMGB vs conventional Rou-en-y Gastric bypass(RYGB) in terms of weight loss and co morbidity improvement in an asian population. Minigastric bypass depite its proven efficacy in asian populations in terms of weight loss is considered inferior to rou-en y gastric bypass in the west.Aim of our study is to compare the two in terms of weight loss and co morbidity reduction and rate of complications.

Materials and Methods: 102 patients matched in terms of Age ,sex, BMI and co morbidities were randomized into 2 groups and 51 patients each underwent MGB and RYGB. Patients were followed up for a period of 2 yrs and the 2 groups were compared in terms of operative time, complications, reoperation rate, weight loss, BMI reduction, glycosylated hemoglobin(diabetes control) and dyslipidemia. Out of the 51 patients in the MGB group 2 patients had early post operative obstruction and required re operation. 1 patient from this group was lost to follow up.4 patients from the RYGB group had early post operative obstruction and required reoperation.1 patient was lost to follow up

Results: Post operatively a minor complication rate of 5% was noted with the minigastric bypass group compared to 4.7 % with rou en y group.Rate of major complications including anastomotic leak was found to be equivalent in both the groups.*

Conclusion: No significant difference was found between the mini-gastric bypass and roux en y gastric bypass groups in terms of BMI, diabetes control, dyslipidemia. There was no significant difference in the anastomotic leak rate. Therefore, Mini-gastric bypass seems to be equally efficacious to roux en y gastric bypass in terms of outcomes and complication rate and warrants worldwide acceptance.