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Tailoring Bariatric Surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Biliopancreatic Diversion with Duodenal Switch.

Publication ,  Journal Article
Sudan, R; Jain-Spangler, K
Published in: J Laparoendosc Adv Surg Tech A
August 2018

BACKGROUND: A need exists to select the most appropriate bariatric operation for a particular patient. One-year data comparing sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (BPD/DS) are sparse. METHODS: The Bariatric Outcomes Longitudinal Database was queried from June 2007 to September 2011 for 30-day and 1-year adverse events, and 1-year weight loss and comorbidity resolution. Propensity scores with inverse probability weighting were used to match for age, gender, body mass index (BMI), ethnicity, and select comorbidities. Multivariate linear and logistic regressions estimated differences and odds ratios (ORs), respectively, for each pairwise bariatric operation comparison. RESULTS: Among 73,702 subjects, 5942 patients underwent SG, 66,324 patients underwent RYGB, and 1436 patients underwent BPD/DS. Compared with SG, decrease in BMI units was greater by 5.3 for BPD/DS and by 2.2 U for RYGB at 1 year. Resolution of gastroesophageal reflux disease (GERD) was best for RYGB (OR = 1.88, 95% confidence interval [CI]: 1.73-2.03) and still good for BPD/DS (OR = 1.57, 95% CI: 1.29-1.90). Hypertension and diabetes mellitus (DM) resolution were better after BPD/DS (OR = 2.12, 95% CI: 1.83-1.64, and OR = 2.53, 95% CI: 2.13-3.00, respectively) and for RYGB were (OR = 1.54, 95% CI: 44-1.64 and OR = 1.63, 95% CI: 1.51-1.75, respectively). Odds of serious adverse events at 1 year were: RYGB, OR = 1.70, 95% CI: 1.45-2.00; BPD/DS, OR = 4.31, 95% CI: 3.06-6.07. CONCLUSIONS: Using SG as reference, RYGB was associated with highest resolution of GERD, whereas BPD/DS was associated with highest resolution of DM and hypertension. These findings can guide decision making regarding choice of bariatric operation.

Duke Scholars

Published In

J Laparoendosc Adv Surg Tech A

DOI

EISSN

1557-9034

Publication Date

August 2018

Volume

28

Issue

8

Start / End Page

956 / 961

Location

United States

Related Subject Headings

  • Weight Loss
  • Treatment Outcome
  • Surgery
  • Propensity Score
  • Postoperative Complications
  • Pediatrics
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Longitudinal Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Sudan, R., & Jain-Spangler, K. (2018). Tailoring Bariatric Surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Biliopancreatic Diversion with Duodenal Switch. J Laparoendosc Adv Surg Tech A, 28(8), 956–961. https://doi.org/10.1089/lap.2018.0397
Sudan, Ranjan, and Kunoor Jain-Spangler. “Tailoring Bariatric Surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Biliopancreatic Diversion with Duodenal Switch.J Laparoendosc Adv Surg Tech A 28, no. 8 (August 2018): 956–61. https://doi.org/10.1089/lap.2018.0397.
Sudan, Ranjan, and Kunoor Jain-Spangler. “Tailoring Bariatric Surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Biliopancreatic Diversion with Duodenal Switch.J Laparoendosc Adv Surg Tech A, vol. 28, no. 8, Aug. 2018, pp. 956–61. Pubmed, doi:10.1089/lap.2018.0397.
Sudan R, Jain-Spangler K. Tailoring Bariatric Surgery: Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and Biliopancreatic Diversion with Duodenal Switch. J Laparoendosc Adv Surg Tech A. 2018 Aug;28(8):956–961.
Journal cover image

Published In

J Laparoendosc Adv Surg Tech A

DOI

EISSN

1557-9034

Publication Date

August 2018

Volume

28

Issue

8

Start / End Page

956 / 961

Location

United States

Related Subject Headings

  • Weight Loss
  • Treatment Outcome
  • Surgery
  • Propensity Score
  • Postoperative Complications
  • Pediatrics
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Longitudinal Studies