Laparoscopic gastric bypass or gastric banding: which operation is best?

Data from the available published literature support that laparoscopic gastric bypass and laparoscopic adjustable gastric banding are safe and effective bariatric procedures for the treatment of morbid obesity. Compared with gastric bypass, gastric banding is commonly associated with a shorteroperative time and length of hospital stay, and lower perioperative morbidity. However, the medium- and long-term weight losses were consistently and dramatically better after gastric bypass. The 2 preoperative factors predictive of poor weight loss in patients with gastric banding were male gender and patients with a BMI greater than or equal to 50 kg/m2. With this knowledge, the final decision regarding gastric bypass versus gastric banding will rely on an in-depth discussion between patients and surgeons with regard to perioperative and late complication data, long-term weight loss and variability of weight loss between the 2 operations, as well as the data regarding the rate for remission of comorbidities between the 2 operations. At the current time, there is ample evidence for surgeons and patients to make a well-informed decision with regard to which operation is best for the individual patient.