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Long-term outcomes after bariatric surgery: A systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding
O'Brien, Paul E. Hindle, Annemarie Brennan, Leah Skinner, Stewart Burton, Paul Smith, Andrew Crosthwaite, Gary Brown, Wendy A.
O'Brien, Paul E.
Hindle, Annemarie
Brennan, Leah
Skinner, Stewart
Burton, Paul
Smith, Andrew
Crosthwaite, Gary
Brown, Wendy A.
Abstract
Introduction: Durability is a key requirement for the broad acceptance of bariatric surgery. We report on durability at and beyond 10 years with a systematic review and meta-analysis of all reports providing data at 10 or more years and a single-centre study of laparoscopic adjustable gastric banding (LAGB) with 20 years of follow-up. Methods: Systematic review with meta-analysis was performed on all eligble reports containing 10 or more years of follow-up data on weight loss after bariatric surgery. In addition, a prospective cohort study of LAGB patients measuring weight loss and reoperation at up to 20 years is presented. Results: Systematic review identified 57 datasets of which 33 were eligible for meta-analysis. Weighted means of the percentage of excess weight loss (%EWL) were calculated for all papers included in the systematic review. Eighteen reports of gastric bypass showed a weighted mean of 56.7%EWL, 17 reports of LAGB showed 45.9%EWL, 9 reports of biliopancreatic bypass +/− duodenal switch showed 74.1%EWL and 2 reports of sleeve gastrectomy showed 58.3%EWL. Meta-analyses of eligible studies demonstrated comparable results. Reoperations were common in all groups. At a single centre, 8378 LAGB patients were followed for up to 20 years with an overall follow-up rate of 54%. No surgical deaths occurred. Weight loss at 20 years (N = 35) was 30.1 kg, 48.9%EWL and 22.2% total weight loss (%TWL). Reoperation rate was initially high but reduced markedly with improved band and surgical and aftercare techniques. Conclusion: All current procedures are associated with substantial and durable weight loss. More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy. Reoperation is likely to remain common across all procedures.
Keywords
weight loss, bariatric surgery, long term, meta-analysis, 20-year follow-up, reoperation rates
Date
2019
Type
Journal article
Journal
Obesity Surgery
Book
Volume
29
Issue
1
Page Range
3-14
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Institute for Learning Sciences and Teacher Education (ILSTE)
Faculty of Education and Arts
Faculty of Health Sciences
Institute for Learning Sciences and Teacher Education (ILSTE)
Faculty of Education and Arts
Relation URI
Source URL
Event URL
Open Access Status
Open access
License
CC BY 4.0
File Access
Open