Current Concepts in Bariatric Surgery

  • Sandeep Aggarwal
  • Pratyusha Priyadarshini
  • Sanjay Agrawal
Part of the GI Surgery Annual book series (GISA, volume 22)


Obesity is a pandemic disease which continues to increase in incidence globally. It has reached alarming proportions and attempts to control this trend appear ineffective. Obesity is associated with reduced life expectancy, increased morbidity and mortality, and higher healthcare costs [1, 2]. Though there are various modalities to treat the disease, none appear to cure it. Multiple interventions which assist in inducing and maintaining weight loss are lifestyle changes, specific diets, medications, devices and surgery. The weight loss achieved by non-surgical means is often inadequate and not sustained. Bariatric surgery has been proven to be the most effective and durable means of weight loss. Bariatric surgery is not only effective in achieving weight loss, it also leads to resolution or improvement of most of the co-morbid conditions associated with obesity. Bariatric surgery leads to 30 % reduction in overall mortality with even greater reduction in cancer and diabetes-related mortality [3–6]. Considering the role of bariatric surgery in resolving most of the co-morbid conditions associated with obesity, the nomenclature has been appropriately changed to metabolic and bariatric surgery.


Bariatric Surgery Gastric Bypass Laparoscopic Sleeve Gastrectomy Excess Weight Loss Adjustable Gastric Banding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Yan LL, Daviglus ML, Liu K, Stamler J, Wang R, Pirzada A, et al. Midlife body mass index and hospitalization and mortality in older age. JAMA 2006;295:190–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Vlad I. Obesity costs UK economy 2bn pounds sterling a year. BMJ 2003;327:1308.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683–93.PubMedCrossRefGoogle Scholar
  4. 4.
    O’Brien PE, Dixon JB, Laurie C, Skinner S, Proietto J, McNeil J, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: A randomized trial. Ann Intern Med 2006;144:625–33.PubMedCrossRefGoogle Scholar
  5. 5.
    Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007;357:753–61.PubMedCrossRefGoogle Scholar
  6. 6.
    Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–52.PubMedCrossRefGoogle Scholar
  7. 7.
    NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med 1991;115:956–61.Google Scholar
  8. 8.
    Centre for Public Health Excellence at NICE (UK), National Collaborating Centre for Primary Care (UK). Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children [Internet]. London:National Institute for Health and Clinical Excellence (UK); 2006. Available from
  9. 9.
    ASMBS Clinical Issues Committee. Bariatric surgery in class I obesity (body mass index 30–35 kg/m2). Surg Obes Relat Dis 2013;9:e1–10.CrossRefGoogle Scholar
  10. 10.
    WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63.CrossRefGoogle Scholar
  11. 11.
    Misra A, Wasir JS, Vikram NK. Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition 2005;21:969–76.PubMedCrossRefGoogle Scholar
  12. 12.
    Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care 2005;28:2745–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Lee WJ, Wang W. Bariatric surgery: Asia-Pacific perspective. Obes Surg 2005;15:751–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Kasama K, Mui W, Lee WJ, Lakdawala M, Naitoh T, Seki Y, et al. IFSO-APC consensus statements 2011. Obes Surg 2012;22:677–84.PubMedCrossRefGoogle Scholar
  15. 15.
    SAGES Guidelines Committee. SAGES guideline for clinical application of laparoscopic bariatric surgery. Surg Endosc 2008;22:2281–300.CrossRefGoogle Scholar
  16. 16.
    Angrisani L, Lorenzo M, Borrelli V. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial. Surg Obes Relat Dis 2007;3:127–32; discussion 132–3.PubMedCrossRefGoogle Scholar
  17. 17.
    Tice JA, Karliner L, Walsh J, Petersen AJ, Feldman MD. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med 2008;121:885–93.PubMedCrossRefGoogle Scholar
  18. 18.
    O’Brien PE, McPhail T, Chaston TB, Dixon JB. Systematic review of medium-term weight loss after bariatric operations. Obes Surg 2006;16:1032–40.PubMedCrossRefGoogle Scholar
  19. 19.
    Kehagias I, Karamanakos SN, Argentou M, Kalfarentzos F. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obes Surg 2011;21:1650–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Clinical Issues Committee of American Society for Metabolic and Bariatric Surgery. Sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis 2007;3:573–6.CrossRefGoogle Scholar
  21. 21.
    Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 2010;252:319–24.PubMedCrossRefGoogle Scholar
  22. 22.
    Laurenius A, Taha O, Maleckas A, Lönroth H, Olbers T. Laparoscopic biliopancreatic diversion/duodenal switch or laparoscopic Roux-en-Y gastric bypass for super-obesity-weight loss versus side effects. Surg Obes Relat Dis 2010;6:408–14.PubMedCrossRefGoogle Scholar
  23. 23.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: A systematic review and meta-analysis. JAMA 2004;292:1724–37.PubMedCrossRefGoogle Scholar
  24. 24.
    Søvik TT, Aasheim ET, Taha O, Engström M, Fagerland MW, Björkman S, et al. Weight loss, cardiovascular risk factors, and quality of life after gastric bypass and duodenal switch: A randomized trial. Ann Intern Med 2011;155:281–91.PubMedCrossRefGoogle Scholar
  25. 25.
    Karamanakos SN, Vagenas K, Kalfarentzos F, Alexandrides TK. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: A prospective, double blind study. Ann Surg 2008;247:401–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Prachand VN, Ward M, Alverdy JC. Duodenal switch provides superior resolution of metabolic comorbidities independent of weight loss in the super-obese (BMI > or =50 kg/m2) compared with gastric bypass. J Gastrointest Surg 2010;14:211–20.PubMedCrossRefGoogle Scholar
  27. 27.
    Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: Systematic review and meta-analysis. Am J Med 2009;122:248–256.e5.Google Scholar
  28. 28.
    Hedberg J, Sundbom M. Superior weight loss and lower HbA1c 3 years after duodenal switch compared with Roux-en-Y gastric bypass—a randomized controlled trial. Surg Obes Relat Dis 2012;8:338–43.PubMedCrossRefGoogle Scholar
  29. 29.
    Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012;366:1567–76.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Leccesi L, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med 2012;366:1577–85.PubMedCrossRefGoogle Scholar
  31. 31.
    Wei YF, Tseng WK, Huang CK, Tai CM, Hsuan CF, Wu HD. Surgically induced weight loss, including reduction in waist circumference, is associated with improved pulmonary function in obese patients. Surg Obes Relat Dis 2011;7:599–604.PubMedCrossRefGoogle Scholar
  32. 32.
    Prachand VN, Alverdy JC. Gastroesophageal reflux disease and severe obesity: Fundoplication or bariatric surgery? World J Gastroenterol 2010;16:3757–61.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Gutschow CA, Collet P, Prenzel K, Hölscher AH, Schneider PM. Long-term results and gastroesophageal reflux in a series of laparoscopic adjustable gastric banding. J Gastrointest Surg 2005;9:941–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Carter PR, LeBlanc KA, Hausmann MG, Kleinpeter KP, deBarros SN, Jones SM. Association between gastroesophageal reflux disease and laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 2011;7:569–72.PubMedCrossRefGoogle Scholar
  35. 35.
    Howard DD, Caban AM, Cendan JC, Ben-David K. Gastroesophageal reflux after sleeve gastrectomy in morbidly obese patients. Surg Obes Relat Dis 2011;7:709–13.PubMedCrossRefGoogle Scholar
  36. 36.
    Keidar A, Appelbaum L, Schweiger C, Elazary R, Baltasar A. Dilated upper sleeve can be associated with severe postoperative gastroesophageal dysmotility and reflux. Obes Surg 2010;20:140–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Lazoura O, Zacharoulis D, Triantafyllidis G, Fanariotis M, Sioka E, Papamargaritis D, et al. Symptoms of gastroesophageal reflux following laparoscopic sleeve gastrectomy are related to the final shape of the sleeve as depicted by radiology. Obes Surg 2011;21:295–9.PubMedCrossRefGoogle Scholar
  38. 38.
    Chiu S, Birch DW, Shi X, Sharma AM, Karmali S. Effect of sleeve gastrectomy on gastroesophageal reflux disease: A systematic review. Surg Obes Relat Dis 2011;7:510–15.PubMedCrossRefGoogle Scholar
  39. 39.
    Sharma A, Aggarwal S, Ahuja V, Bal C. Evaluation of gastroesophageal reflux before and after sleeve gastrectomy using symptom scoring, scintigraphy, and endoscopy. Surg Obes Relat Dis 2014;10:600–5.PubMedCrossRefGoogle Scholar
  40. 40.
    Sil A, Barr G. Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea. J Laryngol Gtol 2012;126:372–9.CrossRefGoogle Scholar
  41. 41.
    O’Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg 2004;14:23–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Sharaf RN, Weinshel EH, Bini EJ, Rosenberg J, Sherman A, Ren CJ. Endoscopy plays an important preoperative role in bariatric surgery. Obes Surg 2004;14:1367–72.PubMedCrossRefGoogle Scholar
  43. 43.
    Verset D, Houben JJ, Gay F, Elcheroth J, Bourgeois V, Van Gossum A. The place of upper gastrointestinal tract endoscopy before and after vertical banded gastroplasty for morbid obesity. Dig Dis Sci 1997;42:2333–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Schirmer B, Erenoglu C, Miller A. Flexible endoscopy in the management of patients undergoing Roux-en-Y gastric bypass. Obes Surg 2002;12:634–8.PubMedCrossRefGoogle Scholar
  45. 45.
    Kim JJ, Schirmer B. Safety and efficacy of simultaneous cholecystectomy at Roux-en-Y gastric bypass. Surg Obes Relat Dis 2009;5:48–53.PubMedCrossRefGoogle Scholar
  46. 46.
    Hamad GG, Ikramuddin S, Gourash WF, Schauer PR. Elective cholecystectomy during laparoscopic Roux-en-Y gastric bypass: Is it worth the wait? Obes Surg 2003;13:76–81.PubMedCrossRefGoogle Scholar
  47. 47.
    Sugerman HJ, Brewer WH, Shiffman ML, Brolin RE, Fobi MA, Linner JH, et al. A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss. Am J Surg 1995;169:91–6; discussion 96–7.PubMedCrossRefGoogle Scholar
  48. 48.
    De Waele B, Lauwers M, Van Nieuwenhove Y, Delvaux G. Outpatient laparoscopic gastric banding: Initial experience. Obes Surg 2004;14:1108–10.PubMedCrossRefGoogle Scholar
  49. 49.
    Birkmeyer NJ, Finks JF, English WJ, Carlin AM, Hawasli AA, Genaw JA, et al. Risks and benefits of prophylactic inferior vena cava filters in patients undergoing bariatric surgery. J Hosp Med 2013;8:173–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Collins J, McCloskey C, Titchner R, Goodpaster B, Hoffman M, Hauser D, et al. Preoperative weight loss in high-risk superobese bariatric patients: A computed tomography-based analysis. Surg Obes Relat Dis 2011;7:480–5.PubMedCrossRefGoogle Scholar
  51. 51.
    Alami RS, Morton JM, Schuster R, Lie J, Sanchez BR, Peters A, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis 2007;3:141–5; discussion 145–6.PubMedCrossRefGoogle Scholar
  52. 52.
    Solomon H, Liu GY, Alami R, Morton J, Curet MJ. Benefits to patients choosing preoperative weight loss in gastric bypass surgery: New results of a randomized trial. J Am Coll Surg 2009;208:241–5.PubMedCrossRefGoogle Scholar
  53. 53.
    Kuwada TS, Richardson S, El Chaar M, Norton HJ, Cleek J, Tomcho J, et al. Insurance-mandated medical programs before bariatric surgery: Do good things come to those who wait? Surg Obes Relat Dis 2011;7:526–30.PubMedCrossRefGoogle Scholar
  54. 54.
    Brethauer S. ASMBS position statement on preoperative supervised weight loss requirements. Surg Obes Relat Dis 2011;7:257–60.PubMedCrossRefGoogle Scholar
  55. 55.
    Buffington C, Walker B, Cowan GS Jr, Scruggs D. Vitamin D deficiency in the morbidly obese. Obes Surg 1993;3:421–4.PubMedCrossRefGoogle Scholar
  56. 56.
    Dargent J. Laparoscopic adjustable gastric banding: Lessons from the first 500 patients in a single institution. Obes Surg 1999;9:446–52.PubMedCrossRefGoogle Scholar
  57. 57.
    Brolin RE, Kenler HA, Gorman JH, Cody RP. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg 1992;215:387–95.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: A prospective, randomized clinical trial. Obes Surg 2002;12:540–5.PubMedCrossRefGoogle Scholar
  59. 59.
    Champion JK, Williams M. Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2003;13:596–600.PubMedCrossRefGoogle Scholar
  60. 60.
    Carmody B, DeMaria EJ, Jamal M, Johnson J, Carbonell A, Kellum J, et al. Internal hernia after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 2005;1:543–8.PubMedCrossRefGoogle Scholar
  61. 61.
    Gonzalez R, Lin E, Venkatesh KR, Bowers SP, Smith CD. Gastrojejunostomy during laparoscopic gastric bypass: Analysis of 3 techniques. Arch Surg 2003;138:181–4.PubMedCrossRefGoogle Scholar
  62. 62.
    Hutter MM, Schirmer BD, Jones DB, Ko CY, Cohen ME, Merkow RP, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: Laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg 2011;254:410–20; discussion 420–2.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis 2012;8:e21–6.CrossRefGoogle Scholar
  64. 64.
    Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis 2010;6:1–5.CrossRefGoogle Scholar
  65. 65.
    Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg 2013;23:427–36.PubMedCrossRefGoogle Scholar
  66. 66.
    Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg 2009;19:1605–11.PubMedCrossRefGoogle Scholar
  67. 67.
    Parikh M, Issa R, McCrillis A, Saunders JK, Ude-Welcome A, Gagner M. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: A systematic review and meta-analysis of 9991 cases. Ann Surg 2013;257:231–7.PubMedCrossRefGoogle Scholar
  68. 68.
    Rawlins L, Rawlins MP, Brown CC, Schumacher DL. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis 2013;9:21–5.PubMedCrossRefGoogle Scholar
  69. 69.
    Rosenthal RJ; International Sleeve Gastrectomy Expert Panel, Diaz AA, Arvidsson D, Baker RS, Basso N, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: Best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis 2012;8:8–19.PubMedCrossRefGoogle Scholar
  70. 70.
    Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Übes Relat Dis 2009;5:469–75.CrossRefGoogle Scholar
  71. 71.
    Choi YY, Bae J, Hur KY, Choi D, Kim YJ. Reinforcing the staple line during laparoscopic sleeve gastrectomy: Does it have advantages? A meta-analysis. Obes Surg 2012;22:1206–13.PubMedCrossRefGoogle Scholar
  72. 72.
    Albanopoulos K, Alevizos L, Flessas J, Menenakos E, Stamou KM, Papailiou J, et al. Reinforcing the staple line during laparoscopic sleeve gastrectomy: Prospective randomized clinical study comparing two different techniques. Preliminary results. Obes Surg 2012;22:42–6.PubMedCrossRefGoogle Scholar
  73. 73.
    Scopinaro N, Gianetta E, Civalleri D, Bonalumi U, Bachi V. Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg 1979;66:618–20.PubMedCrossRefGoogle Scholar
  74. 74.
    Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267–82.PubMedCrossRefGoogle Scholar
  75. 75.
    Marceau P, Hould FS, Simard S, Lebel S, Bourque RA, Potvin M, et al. Biliopancreatic diversion with duodenal switch. World J Surg 1998;22:947–54.PubMedCrossRefGoogle Scholar
  76. 76.
    Sudan R, Bennett KM, Jacobs DO, Sudan DL. Multifactorial analysis of the learning curve for robot-assisted laparoscopic biliopancreatic diversion with duodenal switch. Ann Surg 2012;255:940–5.PubMedCrossRefGoogle Scholar
  77. 77.
    Dixon JB, O’Brien PE. Laparoscopic adjustable gastric banding: outcomes. In: Schauer PR, Schirmer BD, Brethauer SA (eds). Minimally invasive bariatric surgery. New York:Springer; 2007:189–96.Google Scholar
  78. 78.
    Dixon JB, O’Brien PE. Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg 2002;184(6B):51S–54S.PubMedCrossRefGoogle Scholar
  79. 79.
    Weiner R, Blanco-Engert R, Weiner S, Matkowitz R, Schaefer L, Pomhoff I. Outcome after laparoscopic adjustable gastric banding—8 years experience. Obes Surg 2003;13:427–34.PubMedCrossRefGoogle Scholar
  80. 80.
    Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232:515–29.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Scopinaro N, Gianetta E, Adami GF, Friedman D, Traverso E, Marinari GM, et al. Biliopancreatic diversion for obesity at eighteen years. Surgery 1996;119:261–8.PubMedCrossRefGoogle Scholar
  82. 82.
    Himpens J, Dapri G, Cadière GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: Results after 1 and 3 years. Obes Surg 2006;16:1450–6.PubMedCrossRefGoogle Scholar
  83. 83.
    Greenburg DL, Lettieri CJ, Eliasson AH. Effects of surgical weight loss on measures of obstructive sleep apnea: A meta-analysis. Am J Med 2009;122:535–42.PubMedCrossRefGoogle Scholar
  84. 84.
    Haines KL, Nelson LG, Gonzalez R, Torrella T, Martin T, Kandil A, et al. Objective evidence that bariatric surgery improves obesity-related obstructive sleep apnea. Surgery 2007;141:354–8.PubMedCrossRefGoogle Scholar
  85. 85.
    Sarkhosh K, Switzer NJ, El-Hadi M, Birch DW, Shi X, Karmali S. The impact of bariatric surgery on obstructive sleep apnea: A systematic review. Obes Surg 2013;23:414–23.PubMedCrossRefGoogle Scholar
  86. 86.
    Boulet LP, Turcotte H, Martin J, Poirier P. Effect of bariatric surgery on airway response and lung function in obese subjects with asthma. Respir Med 2012;106:651–60.PubMedCrossRefGoogle Scholar
  87. 87.
    Wilson PW, D’Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: The Framingham experience. Arch Intern Med 2002;162:1867–72.PubMedCrossRefGoogle Scholar
  88. 88.
    Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H, et al. Bariatric surgery and long-term cardiovascular events. JAMA 2012;307:56–65.PubMedCrossRefGoogle Scholar
  89. 89.
    Hofsø D, Nordstrand N, Johnson LK, Karlsen TI, Hager H, Jenssen T, et al. Obesity-related cardiovascular risk factors after weight loss: A clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol 2010;163:735–45.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Alpert MA, Lambert CR, Panayiotou H, Terry BE, Cohen MV, Massey CV, et al. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol 1995;76:1194–7.PubMedCrossRefGoogle Scholar
  91. 91.
    Lakhani M, Fein S. Effects of obesity and subsequent weight reduction on left ventricular function. Cardiol Rev 2011;19:1–4.PubMedCrossRefGoogle Scholar
  92. 92.
    Ashrafian H, le Roux CW, Darzi A, Athanasiou T. Effects of bariatric surgery on cardiovascular function. Circulation 2008;118:2091–102.PubMedCrossRefGoogle Scholar
  93. 93.
    Leibson CL, Williamson DF, Melton LJ 3rd, Palumbo PJ, Smith SA, Ransom JE, et al. Temporal trends in BMI among adults with diabetes. Diabetes Care 2001;24:1584–9.PubMedCrossRefGoogle Scholar
  94. 94.
    Benaiges D, Goday A, Ramon JM, Hernandez E, Pera M, Cano JF, et al. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis 2011;7:575–80.PubMedCrossRefGoogle Scholar
  95. 95.
    MacDonald KG Jr, Long SD, Swanson MS, Brown BM, Morris P, Dohm GL, et al. The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg 1997;1:213–20; discussion 220.PubMedCrossRefGoogle Scholar
  96. 96.
    Hayes MT, Hunt LA, Foo J, Tychinskaya Y, Stubbs RS. A model for predicting the resolution of type 2 diabetes in severely obese subjects following Roux-en-Y gastric bypass surgery. Obes Surg 2011;21:910–16.PubMedCrossRefGoogle Scholar
  97. 97.
    Shah PS, Todkar JS, Shah SS. Effectiveness of laparoscopic sleeve gastrectomy on glycemic control in obese Indians with type 2 diabetes mellitus. Surg Obes Relat Dis 2010;6:138–41.PubMedCrossRefGoogle Scholar
  98. 98.
    Todkar JS, Shah SS, Shah PS, Gangwani J. Long-term effects of laparoscopic sleeve gastrectomy in morbidly obese subjects with type 2 diabetes mellitus. Surg Obes Relat Dis 2010;6:142–5.PubMedCrossRefGoogle Scholar
  99. 99.
    Gill RS, Birch DW, Shi X, Sharma AM, Karmali S. Sleeve gastrectomy and type 2 diabetes mellitus: A systematic review. Surg Obes Relat Dis 2010;6:707–13.PubMedCrossRefGoogle Scholar
  100. 100.
    Eid GM, Brethauer S, Mattar SG, Titchner RL, Gourash W, Schauer PR. Laparoscopic sleeve gastrectomy for super obese patients: Forty-eight percent excess weight loss after 6 to 8 years with 93 % follow-up. Ann Surg 2012;256:262–5.PubMedCrossRefGoogle Scholar
  101. 101.
    Sultan S, Gupta D, Parikh M, Youn H, Kurian M, Fielding G, et al. Five-year outcomes of patients with type 2 diabetes who underwent laparoscopic adjustable gastric banding. Surg Obes Relat Dis 2010;6:373–6.PubMedCrossRefGoogle Scholar
  102. 102.
    Murray P, Chune GW, Raghavan VA. Legacy effects from DCCT and UKPDS: What they mean and implications for future diabetes trials. Curr Atheroscler Rep 2010;12:432–9.PubMedCrossRefGoogle Scholar
  103. 103.
    Frohlich ED. Obesity and hypertension. Hemodynamic aspects. Ann Epidemiol 1991;1: 287–93.PubMedCrossRefGoogle Scholar
  104. 104.
    Lee WJ, Huang MT, Wang W, Lin CM, Chen TC, Lai IR. Effects of obesity surgery on the metabolic syndrome. Arch Surg 2004;139:1088–92.PubMedCrossRefGoogle Scholar
  105. 105.
    Frezza EE, Ikramuddin S, Gourash W, Rakitt T, Kingston A, Luketich J, et al. Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2002;16:1027–31.PubMedCrossRefGoogle Scholar
  106. 106.
    Zhang N, Maffei A, Cerabona T, Pahuja A, Omana J, Kaul A. Reduction in obesity-related comorbidities: Is gastric bypass better than sleeve gastrectomy? Surg Endosc 2013;27:1273–80.PubMedCrossRefGoogle Scholar
  107. 107.
    Beymer C, Kowdley KV, Larson A, Edmonson P, Dellinger EP, Flum DR. Prevalence and predictors of asymptomatic liver disease in patients undergoing gastric bypass surgery. Arch Surg 2003;138:1240–4.PubMedCrossRefGoogle Scholar
  108. 108.
    Mattar SG, Velcu LM, Rabinovitz M, Demetris AJ, Krasinskas AM, Barinas-Mitchell E, et al. Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann Surg 2005;242:610–17; discussion 618–20.PubMedPubMedCentralGoogle Scholar
  109. 109.
    Rabl C, Campos GM. The impact of bariatric surgery on non-alcoholic steatohepatitis. Semin Liver Dis 2012;32:80–91.PubMedCrossRefGoogle Scholar
  110. 110.
    Iossi MF, Konstantakos EK, Teel DD 2nd, Sherwood RJ, Laughlin RT, Coffey MJ, et al. Musculoskeletal function following bariatric surgery. Obesity (Silver Spring) 2013;21:1104–10.Google Scholar
  111. 111.
    Deitel M, Stone E, Kassam HA, Wilk EJ, Sutherland DJ. Gynecologic-obstetric changes after loss of massive excess weight following bariatric surgery. J Am Coll Nutr 1988;7:147–53.PubMedCrossRefGoogle Scholar
  112. 112.
    González Centeno A, Hernández Marín I, Mendoza R, Tovar Rodríguez JM, Ayala AR. [Polycystic ovarian disease: clinical and biochemical expression]. Ginecol Obstet Mex 2003;71:253–8.PubMedGoogle Scholar
  113. 113.
    Eid GM, Cottam DR, Velcu LM, Mattar SG, Korytkowski MT, Gosman G, et al. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. Surg Obes Relat Dis 2005;1:77–80.PubMedCrossRefGoogle Scholar
  114. 114.
    Jamal M, Gunay Y, Capper A, Eid A, Heitshusen D, Samuel I. Roux-en-Y gastric bypass ameliorates polycystic ovary syndrome and dramatically improves conception rates: A 9-year analysis. Surg Obes Relat Dis 2012;8:440–4.PubMedCrossRefGoogle Scholar
  115. 115.
    Allen JW, Lagardere AO. Laparoscopic adjustable gastric banding: Complications. In: Schauer PR, Schirmer BD, Brethauer SA (eds). Minimally invasive bariatric surgery. New York:Springer; 2007:205–12.Google Scholar
  116. 116.
    Angrisani L, Cutolo PP, Formisano G, Nosso G, Vitolo G. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis 2013;9:405–13.PubMedCrossRefGoogle Scholar
  117. 117.
    Parakh S, Soto E, Merola S. Diagnosis and management of internal hernias after laparoscopic gastric bypass. Obes Surg 2007;17:1498–502.PubMedCrossRefGoogle Scholar
  118. 118.
    Gumbs AA, Duffy AJ, Bell RL. Incidence and management of marginal ulceration after laparoscopic Roux-Y gastric bypass. Surg Obes Relat Dis 2006;2:460–3.PubMedCrossRefGoogle Scholar
  119. 119.
    Vance PL, de Lange EE, Shaffer HA Jr, Schirmer B. Gastric outlet obstruction following surgery for morbid obesity: Efficacy of fluoroscopically guided balloon dilation. Radiology 2002;222:70–2.PubMedCrossRefGoogle Scholar
  120. 120.
    Masoomi H, Kim H, Reavis KM, Mills S, Stamos MJ, Nguyen NT. Analysis of factors predictive of gastrointestinal tract leak in laparoscopic and open gastric bypass. Arch Surg 2011;146:1048–51.PubMedCrossRefGoogle Scholar
  121. 121.
    Thodiyil PA, Yenumula P, Rogula T, Gorecki P, Fahoum B, Gourash W, et al. Selective nonoperative management of leaks after gastric bypass: Lessons learned from 2675 consecutive patients. Ann Surg 2008;248:782–92.PubMedCrossRefGoogle Scholar
  122. 122.
    Hamoui N, Crookes PF, Kaufman HS. Percutaneous gastric drainage as a treatment for small bowel obstruction after gastric bypass. Obes Surg 2007;17:1411–12.PubMedCrossRefGoogle Scholar
  123. 123.
    Aarts EO, van Wageningen B, Janssen IM, Berends FJ. Prevalence of anemia and related deficiencies in the first year following laparoscopic gastric bypass for morbid obesity. J Obes 2012;2012:193705.PubMedPubMedCentralCrossRefGoogle Scholar
  124. 124.
    Clements RH, Yellumahanthi K, Wesley M, Ballem N, Bland KI. Hyperparathyroidism and vitamin D deficiency after laparoscopic gastric bypass. Am Surg 2008;74:469–74; discussion 474–5.PubMedGoogle Scholar
  125. 125.
    Lalor PF, Tucker ON, Szomstein S, Rosenthal RJ. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 2008;4:33–8.PubMedCrossRefGoogle Scholar
  126. 126.
    Csendes A, Braghetto I, León P, Burgos AM. Management of leaks after laparoscopic sleeve gastrectomy in patients with obesity. J Gastrointest Surg 2010;14:1343–8.PubMedCrossRefGoogle Scholar
  127. 127.
    Gehrer S, Kern B, Peters T, Christoffel-Courtin C, Peterli R. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg 2010;20:447–53.PubMedCrossRefGoogle Scholar
  128. 128.
    Rutledge R. The mini-gastric bypass: Experience with the first 1,274 cases. Obes Surg 2001;11:276–80.PubMedCrossRefGoogle Scholar
  129. 129.
    Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK. ‘Mini’ gastric bypass: Systematic review of a controversial procedure. Obes Surg 2013;23:1890–8.PubMedCrossRefGoogle Scholar
  130. 130.
    Lee WJ, Ser KH, Lee YC, Tsou JJ, Chen SC, Chen JC. Laparoscopic Roux-en-Y vs. minigastric bypass for the treatment of morbid obesity: A 10-year experience. Obes Surg 2012;22:1827–34.PubMedCrossRefGoogle Scholar
  131. 131.
    Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Huang MT. Laparoscopic Roux-en-Y versus minigastric bypass for the treatment of morbid obesity: A prospective randomized controlled clinical trial. Ann Surg 2005;242:20–8.PubMedPubMedCentralCrossRefGoogle Scholar
  132. 132.
    Fisher BL, Buchwald H, Clark W, Champion JK, Fox SR, MacDonald KG, et al. Mini-gastric bypass controversy. Obes Surg 2001;11:773–7.PubMedCrossRefGoogle Scholar
  133. 133.
    Olchowski S, Timms MR, O’Brien P, Bauman R, Quattlebaum JK. More on mini-gastric bypass. Obes Surg 2001;11:532.PubMedCrossRefGoogle Scholar
  134. 134.
    Johnson WH, Fernanadez AZ, Farrell TM, Macdonald KG, Grant JP, McMahon RL, et al. Surgical revision of loop (“mini”) gastric bypass procedure: Multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis 2007;3:37–41.PubMedCrossRefGoogle Scholar
  135. 135.
    Collins BJ, Miyashita T, Schweitzer M, Magnuson T, Harmon JW. Gastric bypass: Why Roux-en-Y? A review of experimental data. Arch Surg 2007;142:1000–3; discussion 1004.PubMedCrossRefGoogle Scholar
  136. 136.
    Babor R, Booth M. Adenocarcinoma of the gastric pouch 26 years after loop gastric bypass. Obes Surg 2006;16:935–8.PubMedCrossRefGoogle Scholar
  137. 137.
    Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: Six-year study in 2,410 patients. Obes Surg 2005;15:1304–8.PubMedCrossRefGoogle Scholar
  138. 138.
    Noun R, Skaff J, Riachi E, Daher R, Antoun NA, Nasr M. One thousand consecutive minigastric bypass: Short- and long-term outcome. Obes Surg 2012;22:697–703.PubMedCrossRefGoogle Scholar
  139. 139.
    Lee WJ, Lee YC, Ser KH, Chen SC, Chen JC, Su YH. Revisional surgery for laparoscopic minigastric bypass. Surg Obes Relat Dis 2011;7:486–91.PubMedCrossRefGoogle Scholar

Copyright information

© T.K. Chattopadhyay 2015

Authors and Affiliations

  • Sandeep Aggarwal
    • 1
  • Pratyusha Priyadarshini
    • 1
  • Sanjay Agrawal
    • 2
  1. 1.Department of Surgical DisciplinesAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of SurgeryHomerton University HospitalLondonUK

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