Laparoscopic Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass for Morbid Obesity: A Meta-Analysis

Abstract

Introduction: Laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) are the two most common bariatric procedures worldwide. This review provides a comparative analysis of their efficacy and safety.

Methods: We conducted a search for RCTs and matched cohort studies comparing LSG and LRYGB. Primary outcomes were percentage of excess weight loss (%EWL) at intermediate and long-term follow-up and resolution of obesity-related comorbidities like type 2 diabetes.

Results: The analysis included 45 studies. LRYGB resulted in slightly greater %EWL and higher rates of diabetes remission compared to LSG, particularly at follow-up beyond three years. However, LSG had a shorter operative time, lower rates of early major complications, and a reduced risk of long-term internal hernia.

Discussion: LRYGB offers superior metabolic and weight loss outcomes, while LSG has a more favorable short-term safety profile. The choice of procedure should be individualized based on patient goals, comorbidities, and surgical risk.

Conclusion: LRYGB provides superior long-term weight loss and diabetes resolution, but LSG is a safer procedure with fewer major complications.