PL-13: Comparative excess body weight loss from laparoscopic adjustable gastric band and laparoscopic Roux-en-Y gastric bypass in a U.S. center over three years

Diabetes is a well-recognized and treatable risk factor for cardiac disease, and one of many comorbidities associated with obesity. The aim of this study was to evaluate the clinical outcome of a cohort of morbidly obese patients with documented diabetes who underwent laparoscopic Roux-en-Y gastric bypass. Fifty-nine patients with sufficient follow-up were included in the study. Mean preoperative duration of diabetes was 68 months. At 1 month postoperatively, mean excess body weight loss was 17 per cent with 29 patients (49%) showing improvement and 21 patients (36%) having remission of their disease. Mean excess body weight loss was 67 per cent at 12 months postoperatively with 25 patients (42%) showing improvement and 34 patients (58%) having remission of diabetes. Mean preoperative fasting blood glucose level decreased from 152 g/dL preoperatively to 100 g/dL at 12 months (P = 0.02), whereas glycosylated hemoglobin decreased from 7.9 per cent to 5.7 per cent, respectively (P < 0.01). Patients with remission of diabetes had a shorter length of condition compared with patients with only improvement (43 vs 103 months, P < 0.01). Weight loss associated with laparoscopic gastric bypass significantly improves diabetes control and results in discontinuation or marked reduction of antidiabetic medications in the majority of patients. Improvement in glucose control occurs as early as 1 month postoperatively.

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Revisional Adjustable Gastric Band in Roux-en-Y Gastric Bypass—Is It Worth It?

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-021-05045-7 ◽

2021 ◽

Author(s):

Ioannis I. Lazaridis ◽

Marko Kraljević ◽

Julian Süsstrunk ◽

Thomas Köstler ◽

Urs Zingg ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Gastric Band ◽

Sleep Apnea Syndrome ◽

Laparoscopic Adjustable Gastric Band ◽

Adjustable Gastric Band ◽

High Rate ◽

Weight Changes ◽

Obstructive Sleep

Abstract Purpose A subset of patients undergoing Roux-en-Y gastric bypass (RYGB) presents with either insufficient weight loss or weight regain. Data on the revisional restrictive options including laparoscopic adjustable gastric band (LAGB) is scarce. This study analyzes the mid-term efficacy and safety of LAGB as a revisional procedure after RYGB. Methods Data of all patients with revisional LAGB after primary RYGB between January 2011 and May 2019 were retrospectively reviewed. Outcomes included assessment of weight changes, resolution of comorbidities, and early and late complications during the study period. Results Twenty patients were included. The median Body Mass Index (BMI) before revisional LAGB was 34.8 (interquartile range [IQR] 31.9–38.1) kg/m2. After a median follow-up of 33.5 (IQR 19.5–76.5) months, the median BMI was 28.7 (IQR 26.1–32.2) kg/m2. The median additional Excess Weight Loss (EWL) was 37.6% (IQR 23–44.4), leading to a median total EWL of 79.5% (IQR 54.4–94.6). BMI and EWL post-LAGB improved significantly compared to BMI and EWL pre-LAGB (p<0.001 and p<0.001, respectively). Obstructive sleep apnea syndrome resolved 6 months after LAGB in one patient. Three band deflations occurred during the follow-up. Six patients underwent band removal after a median time of 19 (IQR 15.8–26) months. Overall, thirteen patients underwent a reoperation. There was no loss of follow-up until 5 years. After that, two patients were lost to follow-up. Conclusion LAGB may be a salvage option after failed RYGB. However, the high rate of revisions after secondary LAGB needs to be taken into consideration.

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6M50LSG Scoring System Increased the Proportion of Adequate Excess Body Weight Loss for Suspected Poor Responders After Laparoscopic Sleeve Gastrectomy in Asian Population

Obesity Surgery ◽

10.1007/s11695-021-05776-1 ◽

2021 ◽

Author(s):

Jian-Han Chen ◽

Hui-Ming Lee ◽

Chung-Yen Chen ◽

Ying-Chen Chen ◽

Chia-Chen Lin ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Scoring System ◽

Body Weight Loss ◽

Asian Population ◽

Poor Responders ◽

Excess Body Weight

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Weight Loss Outcomes of Laparoscopic Adjustable Gastric Band with Plication: a Single Center Experience of 66 Patients with 18-Month Follow-Up

Obesity Surgery ◽

10.1007/s11695-018-3512-5 ◽

2018 ◽

Vol 29 (1) ◽

pp. 246-251 ◽

Cited By ~ 1

Author(s):

Helmuth Billy ◽

Amit Surve ◽

Ryan Fairley ◽

Daniel Cottam ◽

Austin Cottam ◽

...

Keyword(s):

Weight Loss ◽

Gastric Band ◽

Laparoscopic Adjustable Gastric Band ◽

Adjustable Gastric Band ◽

Single Center ◽

Single Center Experience ◽

Weight Loss Outcomes

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Gastric Bypass Surgery Causes Body Weight Loss Without Reducing Food Intake in Rats

Obesity Surgery ◽

10.1007/s11695-007-9392-8 ◽

2008 ◽

Vol 18 (4) ◽

pp. 415-422 ◽

Cited By ~ 25

Author(s):

Marianne W. Furnes ◽

Karin Tømmerås ◽

Carl-Jørgen Arum ◽

Chun-Mei Zhao ◽

Duan Chen

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Food Intake ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Body Weight Loss

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Characterization of one anastomosis gastric bypass and impact of biliary and common limbs on bile acid and postprandial glucose metabolism in a minipig model

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00356.2020 ◽

2021 ◽

Author(s):

Camille Marciniak ◽

Oscar Chávez-Talavera ◽

Robert Caiazzo ◽

Thomas Hubert ◽

Lorea Zubiaga ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Glucose Metabolism ◽

Glucose Homeostasis ◽

Body Weight Loss ◽

Metabolic Effects ◽

One Anastomosis Gastric Bypass ◽

Alimentary Limb ◽

The Common

Background/Objectives: The alimentary limb has been proposed to be a key driver of the weight-loss-independent metabolic improvements that occur upon bariatric surgery. However, the One Anastomosis Gastric Bypass (OAGB) procedure, consisting of one long biliary limb and a short common limb, induces stronger beneficial metabolic effects compared to Roux-en-Y Gastric Bypass (RYGB) in humans, despite the lack of an alimentary limb. The aim of this study was to assess the role of the biliary and common limbs in the weight-loss and metabolic effects that occur upon OAGB. Subjects/Methods: OAGB and sham surgery, with or without modifications of the length of either the biliary limb or the common limb, were performed in Gottingen-like minipigs. Weight loss, metabolic changes, and the effects on plasma and intestinal bile acids (BAs) were assessed 15 days after surgery. Results: OAGB significantly decreased body weight, improved glucose homeostasis, increased postprandial GLP-1 and fasting plasma BAs, and qualitatively changed the intestinal BA species composition. Resection of the biliary limb prevented the body weight loss effects of OAGB and attenuated the postprandial GLP-1 increase. Improvements in glucose homeostasis along with changes in plasma and intestinal BAs occurred after OAGB regardless of the biliary limb length. Resection of only the common limb reproduced the glucose homeostasis effects and the changes in intestinal BAs. Conclusions: Our results suggest that the changes in glucose metabolism and BAs after OAGB are mainly mediated by the length of the common limb, whereas the length of the biliary limb contributes to body weight loss.

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