Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects
Gastric Bypass and Vertical Banded Gastroplasty- a Prospective Randomized Comparison and 5-Year Follow-up
Background : a prospect i ve r and omized study was undertaken to compare the outcome of vertical b and ed gastroplasty ( VBG ) and gastric bypass ( GBP ) in patients with clinical ly severe obesity . Methods : eligibility criteria included Class IV obesity , < 50 years old and a history of at least one attempt of non-operative weight loss . Patients were managed conservatively for 3 months prior to surgery . Patients were followed post-operatively and monitored for early and late complications and their weight loss outcome for up to 5 years . Results : 44 patients were recruited . Two patients withdrew within 4 weeks and were excluded . Twenty subjects had a GBP and 22 a VBG .  There were no significant differences with respect to age , gender , maximum or pre-operative weight between the groups ( p > 0.05 ) . Patients who underwent GBP demonstrated significantly greater post-operative weight loss ( p < 0.05 ) which was apparent from 6 months onwards . There were no deaths , pulmonary emboli , post-operative leaks or wound dehiscence . There were no instances of staple-line disruption . Symptomatic ulcer disease , confirmed endoscopically , developed in 25 % of GBP patients . Nine patients developed gallstones post-operatively of whom five were in the VBG and four in the GBP group . Conclusions : weight loss following GBP was maintained , while VBG patients slowly regained
Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects