肥満と減量療法のジャーナル

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Comparison of Weight Loss Outcomes and Resolution of Obesity Related Comorbidities Following Laparoscopic Sleeve Gastrectomy and Laparoscopic Gastric Bypass - Experience at a Single Metabolic and Bariatric Surgery Center of Srilanka

Kariyawasam GMD, Wijerathne TK, Abeysinghe AAGK

Laparoscopic gastric bypass (LGBP) and laparoscopic sleeve gastrectomy (LSG) are two of the commonest bariatric procedures performed in Asia. Gastric bypass performed either as Roux-en-Y gastric bypass or Mini-gastric bypass has shown to be a safe and effective procedure with good long term results. LSG, initially used as a first stage procedure in complex bariatric procedures is rapidly gaining popularity. With a simpler technical aspect and easy learning curve, LSG has shown good short term results in weight loss. The short and long term outcomes of these procedures are affected by multiple factors. Regional studies are required to assess effectiveness of each procedure and this data helps in selecting the suitable surgical approach to individual patients. In this retrospective study we analyzed weight loss outcomes and response of medical comorbidities between the two procedures after 1 year of follow-up. From 2017 January and 2021 January, 138 patients who underwent primary bariatric surgery were included in the study and were assigned for Laparoscopic Sleeve Gastrectomy (n= 84) and Laparoscopic Gastric Bypass (n= 54) by patient choice and informed consent. Data was collected on demographic factors, pre-operative body weight, body mass index (BMI), waist circumference, total body fat percentage and presence of obesity-related comorbidities. After 1 year of follow up weight loss outcomes and resolution of comorbidities were assessed. Both groups were comparable in age, sex and BMI. One year after surgery the LGBP group showed an excess weight loss percentage (%EWL) of 75.46% while the LSG group had a %EWL of 71.35% without statistical significance. Reduction in total body fat content and waist circumference was comparable between the two procedures. Patients in both groups had similar results for improvement and resolution of comorbidities without any statistical significance between the two procedures. In short term both LSG and LGBP were comparable in effectiveness within a Srilankan study population.