Journal of Evaluation in Clinical Practice

Safety and efficacy of laparoscopic sleeve gastrectomy versus laparoscopic Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Early View

Abstract Background Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux‐en‐Y gastric bypass (LRYGB) are widely performed to cure obesity and obesity‐related diseases. Our aim was to compare these two procedures. Materials and methods An electronic literature search was performed from inception to December 2018. The clinical outcomes between LSG and LRYGB were pooled using software RevMan5.3. Results A total of 1076 patients from 11 studies were analysed. LSG had shorter operation time (mean difference [MD] = −33.81; 95% confidence interval [CI], −46.04 to −21.57; P < .00001) and less early complications rate (risk ratio [RR] = 0.55; 95% CI, 0.36‐0.84; P = .005) compared with LRYGB. There were no significant difference about the readmission rate (RR = 0.57; 95% CI, 0.21‐1.54; P = .27) and re‐operation rate (RR = 0.43; 95% CI, 0.14‐1.27; P = .13) between LSG and LRYGB. The conversion to open rate and mortality rate within 30 days was low in both LSG and LRYGB. Mean hospital stay in LSG group (0.3‐5.2 d) seems shorter than that in the LRYGB group (2.3‐6.6 d). As to the effect of LSG and LRYGB on the percentage of excess weight loss (EWL), there was no significant difference between these two surgeries in EWL (MD = −4.05; 95% CI, −8.89 to 0.80; P = .10). LSG was equal to LRYGB on remission of T2DM (RR = 0.94; 95% CI, 0.84‐1.06; P = .31). Conclusions Both LSG and LRYGB can be performed with very low conversion to open rate and mortality rate. The readmission rate and re‐operation rate are comparable between these two surgeries. The efficacy of these two surgeries on EWL and T2DM is equivalent, but LSG has an advantage over LRYGB in operation time and early complications rate.

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