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University of Basel

17 January 2018

Morbid Obesity: Gastric Bypass and Sleeve Gastrectomy Are Comparable

Surgery in the abdominal cavity is considered to be the most efficient measure for overweight patients: Patient during surgery. (Image: St. Claraspital)
Surgery in the abdominal cavity is considered to be the most efficient measure for overweight patients: Patient during surgery. (Image: St. Claraspital)

In Switzerland, 5,500 operations to combat morbid obesity are conducted every year. Gastric bypasses and sleeve gastrectomy operations perform similarly: patients lose two-thirds of their excess weight in the long term, as researchers from the University of Basel at the St. Claraspital report in the Journal of the American Medical Association (JAMA). When it comes to gastric acid reflux, the bypass clearly shows better results.

Two types of surgery for severe obesity: In the case of gastric bypass, the stomach is bypassed by a part of the small intestine (left), while in the case of the peritoneum, the stomach volume is reduced (right). (Illustrations: USZ, Visceral Surgery)
Two types of surgery for severe obesity: In the case of gastric bypass, the stomach is bypassed by a part of the small intestine (left), while in the case of the peritoneum, the stomach volume is reduced (right). (Illustrations: USZ, Visceral Surgery)

Improvement in gastric acid reflux

Patients with existing gastric acid reflux benefited more from a gastric bypass operation:  after this procedure, symptoms were eliminated in 60%, compared to only 25% after a sleeve gastrectomy. Sleeve gastrectomy also led to a deterioration or new onset of gastric acid reflux significantly more often. Further surgery or interventions were needed in 22% of gastric bypasses and 16% of sleeve gastrectomy operations.

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