Initial evaluation of laparoscopic Roux-en-Y gastric bypass and adjustable gastric banding in Korea: a single institution study.

Background: Obesity becomes a global epidemic disease, and bariatric surgery is increasing in Korea as well as in western countries. The first laparoscopic Roux-en-Y gastric bypass (LRYGBP) was performed in 2003, and the Lap Band was approved for use in Korea in 2004. There are no data regarding gastric bypass and adjustable gastric banding regarding weight loss as well as changing of pre-existing comorbidities up to date.

Methods: St. Mary's Hospital Center, main leader of bariatric surgery in Korea, performed 76 weight loss operations [LRYGBP = 25, laparoscopic adjustable gastric banding (LAGB) = 51] for morbid obesity. We retrospectively reviewed a series of bariatric cases and examined changes of weight loss, postoperative complications, and pre-existing comorbidities between two procedures.

Results: There were no significant differences in age, BMI, sex distribution, pre-existing comorbidities in two procedures. Patients undergoing LRYGBP had longer operative times, more blood loss, and longer hospital stays. There is significant difference regarding postoperative complication (p < 0.05) but neither for mortality nor pulmonary embolism with both procedures. Percentage of excess weight loss (%EWL) of LRYGBP at 12, 24, and 36 months were 76.9%, 79.7%, and 85.8%, and %EWL of LAGB were 46.8%, 55.1%, 63.3%, respectively. The patients in the LRYGBP who has dyslipidemia, sleep apnea, degenerative joint disease, and diabetes mellitus were more likely to improve than the patients after LAGB at early postoperative period.

Conclusions: The results of our initial study indicate that LRYGBP and LAGB are technically feasible and safe. It is a low rate of major postoperative complications without mortality. LRYGBP and LAGB are quite satisfactory and promising bariatric procedures with significant weight loss and improvement of obesity-related metabolic comorbidities in Korean.