Sleeve gastrectomy is emerging to be the procedure of choice in the management of severe obesity. The aim of this study was to analyze outcomes between patients who underwent laparoscopic sleeve gastrectomy (LSG) versus laparoscopic adjustable gastric banding (LAGB). A retrospective matched cohort analysis was performed between 150 patients who underwent LSG versus 150 patients who underwent LAGB. The cohorts were matched for age, gender, body mass index (BMI), and preoperative comorbidities. Length of hospital stay (1.6 vs 1.1 days, P < 0.01) was longer in the LSG group. Perioperative complications were similar between groups (4.6% for LSG vs 2.0% for LAGB) but the late complication rate was significantly lower in the LSG group (1.3 vs 8.0%). The 30-day reoperation (0 vs 0.7%) and readmission (1.3 vs 1.3%) rates were similar between groups. There were no 90-day mortalities in the study. The mean reduction in BMI was significantly higher for LSG (-11.9 kg/m2 for LSG vs -6.2 kg/m2 for LAGB, P < 0.01) at 1-year follow-up. The number of medications used to control all comorbidities was significantly lower at follow-up compared with baseline for both groups. The mean reduction in the number medications used to control hypertension was greater in the LSG group (-1.00 ± 0.70 vs -0.35 ± 0.70 medications, P < 0.01). LSG has a perioperative safety profile comparable to that of LAGB but achieved significantly better weight loss and control of hypertension with a lower rate of late complications.
Life-threatening late complication after laparoscopic adjustable gastric banding: two cases of gastric necrosis