This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. BJS 2010; 97: 160-166.
Published: 24th December 2009
Authors: T. T. Søvik, O. Taha, E. T. Aasheim, M. Engström, J. Kristinsson, S. Björkman et al.
Background
Laparoscopic Roux‐en‐$fontss=cmss10 scaled 1000 hbox{Y}$ gastric bypass (LRYGB) and laparoscopic biliopancreatic diversion with duodenal switch (LDS) are surgical options for superobesity. A randomized trial was conducted to evaluate perioperative (30‐day) safety and 1‐year results.
Method
Sixty patients with a body mass index (BMI) of 50–60 kg/m2 were randomized to LRYGB or LDS. BMI, percentage of excess BMI lost, complications and readmissions were compared between groups.
Results
Patient characteristics were similar in the two groups. Mean operating time was 91 min for LRYGB and 206 min for LDS (P < 0·001). One LDS was converted to open surgery. Early complications occurred in four patients undergoing LRYGB and seven having LDS (P = 0·327), with no deaths. Median stay was 2 days after LRYGB and 4 days after LDS (P < 0·001). Four and nine patients respectively had late complications (P = 0·121). Mean BMI at 1 year decreased from 54·8 to 38·5 kg/m2 after LRYGB and from 55·2 to 32·5 kg/m2 after LDS; percentage of excess BMI lost was greater after LDS (74·8 versus 54·4 per cent; P < 0·001).
Conclusion
LRYGB and LDS can be performed with comparable perioperative safety in superobese patients. LDS provides greater weight loss in the first year. Registration number: NCT00327912 (