Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Data from IFSO-European Chapter Center of Excellence Program

Melissas, John; Stavroulakis, Konstantinos; Tzikoulis, Vassilis; Peristeri, Angeliki; Papadakis, John A.; Pazouki, Abdolreza; Khalaj, Alireza; Kabir, Ali

doi:10.1007/s11695-016-2395-6

Cited by 60 publications

(41 citation statements)

References 28 publications

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“…Despite the severity of liver disease in our patient cohort, there was no perioperative mortality or liver‐related morbidity. The major morbidity rate in our patient cohort was 3% (1 patient with a gastric staple line leak) and similar to the major morbidity rate with laparoscopic SG in the general bariatric surgery patient population, which ranges from 2.1% to 5.6% . We also noted similar reoperation rates (0% versus 3%) and mean length of hospitalization (2.4 versus 3.0 days) in our patient cohort as compared with published data of outcomes in the overall bariatric surgery population …”

Section: Discussionsupporting

confidence: 85%

“…The major morbidity rate in our patient cohort was 3% (1 patient with a gastric staple line leak) and similar to the major morbidity rate with laparoscopic SG in the general bariatric surgery patient population, which ranges from 2.1% to 5.6%. (19)(20)(21) We also noted similar reoperation rates (0% versus 3%) and mean length of hospitalization (2.4 versus 3.0 days) in our patient cohort as compared with published data of outcomes in the overall bariatric surgery population. (19)(20)(21) Importantly, SG yielded significant sustained weight loss associated with improvement or resolution of obesity-related comorbidities in the majority of patients.…”

Section: Discussionsupporting

confidence: 80%

“…(19)(20)(21) We also noted similar reoperation rates (0% versus 3%) and mean length of hospitalization (2.4 versus 3.0 days) in our patient cohort as compared with published data of outcomes in the overall bariatric surgery population. (19)(20)(21) Importantly, SG yielded significant sustained weight loss associated with improvement or resolution of obesity-related comorbidities in the majority of patients. By 12 months after SG, the absolute reduction in BMI in our cohort was 11.3 kg/m 2 , which compares to a BMI reduction of 11.9 kg/m 2 in the general bariatric surgery population.…”

Section: Discussionsupporting

confidence: 77%

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Outcomes of Sleeve Gastrectomy in Obese Liver Transplant Candidates

2019

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Morbid obesity (body mass index [BMI] ≥40 kg/m2) is a relative contraindication to liver transplantation (LT) at many transplant centers. The safety and efficacy of pre-LT bariatric surgery in morbidly obese LT candidates is unknown. Herein, we describe a cohort study of morbidly obese LT candidates who failed to achieve adequate weight loss through a medically supervised weight loss program and subsequently underwent sleeve gastrectomy (SG) at our institution. In total, 32 LT candidates with a median Model for End-Stage Liver Disease (MELD) score of 12 (interquartile range [IQR], 10–13) underwent SG. All LT candidates had a history of hepatic decompensation, but complications of liver disease were required to be well controlled at the time of SG. Median pre-SG BMI was 45.0 kg/m2 (IQR, 42.1–49.0 kg/m2). There were no perioperative deaths or liver-related morbidity. One patient experienced major perioperative morbidity secondary to a gastric leak, which was managed nonoperatively. Median weight loss at 6 and 12 months after SG was 22.0 kg (IQR, 18.9–26.8 kg) and 31.0 kg (IQR, 23.6–50.3 kg), respectively, corresponding to a percentage of excess body weight lost of 33.4% and 52.4%. Within 6 months after SG, 28 (88%) candidates were deemed eligible for LT. Our center’s experience highlights the potential option of SG in morbidly obese LT candidates with advanced liver disease who might otherwise be excluded from pursuing LT.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 77%

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Outcomes of Sleeve Gastrectomy in Obese Liver Transplant Candidates

2019

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“…The popularity of the LAGB, which used to be the most frequently used bariatric procedure in the first decade of the 2000s, has drastically decreased in recent years due to the unfavorable safety profile in the long-term and the poor long-term weight loss in comparison with the other bariatric procedures (57,58,59). Throughout the years, both surgeries have been demonstrated to be safe and effective for the treatment of obesity (60,61,62,63).…”

Section: Overview Of Surgical Procedures For Obesity and Metabolic DImentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Which metabolic procedure? Comparing outcomes in sleeve gastrectomy and Roux-en Y gastric bypass

Billeter

Herrera

Scheurlen

et al. 2018

European Journal of Endocrinology

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Obesity and its associated comorbidities have become one of the largest challenges for health care in the near future. Conservative therapy for obesity and related comorbidities has a very high failure rate and poor long-term results. Similarly, the conservative and medical management of the majority of metabolic diseases such as type 2 diabetes mellitus are only able to slow down disease progression but have no causal effect on the disease process. Obesity surgery has evolved as a highly effective therapy for severe obesity achieving long-lasting weight loss. Furthermore, several studies have demonstrated the beneficial effects of obesity surgery on reduction of overall mortality, reduction of cardiovascular events and superior control of obesity-related diseases such as type 2 diabetes mellitus, dyslipidemia and also the non-alcoholic steatohepatitis compared to medical therapy. Based on these findings, the term 'metabolic surgery' with the focus on treating metabolic diseases independent of body weight has been coined. Of great interest are recent studies that show that even existing complications of metabolic diseases such as diabetic nephropathy or the non-alcoholic steatohepatitis can be reversed by metabolic surgery. Although metabolic surgery has proven to be a safe and effective treatment for obesity, resolution of comorbidities and enhancing quality of life, it is still uncertain and unclear, which surgical procedure is the most effective to achieve these metabolic effects. The aim of this review is to compare the effects of the two currently most widely used metabolic operations, the Roux-en-Y gastric bypass and the sleeve gastrectomy in the treatment of obesity and its related comorbidities.

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“…Improvements in technology, operative techniques, results of clinical trials and accumulation of experience all contributed to this progress 22. In the most recent publication, the 30‐day mortality from the European center of excellence program was reported to be only 0.012% 23. In conclusion, bariatric/metabolic surgery has had a 10‐fold growth in the past decade but the operation is 100‐fold safer now.…”

Section: Increase In Numbers and Better Safetymentioning

confidence: 99%

Recent advancements in bariatric/metabolic surgery

Lee

Almalki

2017

Annals of Gastroent Surgery

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Obesity and type 2 diabetes mellitus (T2DM) are currently two pan‐endemic health problems worldwide and are associated with considerable increase in morbidity and mortality. Both diseases are closely related and very difficult to control by current medical treatment, including diet, drug therapy and behavioral modification. Bariatric surgery has proven successful in treating not just obesity but also in significantly decreasing overall obesity‐associated morbidities as well as improving quality of life in severely obese patients (body mass index [BMI] >35 kg/m2). A rapid increase in bariatric surgery started in the 2000s when the laparoscopic surgical technique was introduced into this field. Many new procedures had been developed and changed the face of modern bariatric surgery. Recently, bariatric surgery played as gastrointestinal metabolic surgery has been proposed as a new treatment modality for obesity‐related T2DM for patients with BMI >35 kg/m2. Strong evidence has demonstrated that bariatric/metabolic surgery is an effective and durable treatment for obese T2DM patients. Bariatric/metabolic surgery is now becoming an important surgical division. The present article examines and discusses recent advancements in bariatric/metabolic surgery and covers four major fields: (i) the rapid increase in numbers and better safety; (ii) new procedures with better outcomes; (iii) from bariatric to metabolic surgery; and (iv) understanding the mechanisms and personalized treatment.

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Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Data from IFSO-European Chapter Center of Excellence Program

Abstract: Both procedures were performed with very low complications, mortality, readmissions, and reoperations rate. Better weight loss was observed following RYGBP, the first five postoperative years.

Cited by 60 publications

References 28 publications

Outcomes of Sleeve Gastrectomy in Obese Liver Transplant Candidates

Outcomes of Sleeve Gastrectomy in Obese Liver Transplant Candidates

MANAGEMENT OF ENDOCRINE DISEASE: Which metabolic procedure? Comparing outcomes in sleeve gastrectomy and Roux-en Y gastric bypass

Recent advancements in bariatric/metabolic surgery

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