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The two most common obesity surgeries – gastric bypass and gastric sleeve – give few short-term complications and are in that sense equivalent. This is shown by a study at the University of Gothenburg.
Each year, around 5,000 bariatric surgeries are performed in Sweden. The person undergoing surgery normally has a BMI value of at least 40, alternatively 35 if the person also has other severe morbidity linked to obesity.
The most common surgical methods are gastric bypass, when a large part of the stomach and part of the small intestine are switched, and gastric sleeve, when a large part of the stomach is surgically removed. The purpose of the current study was to compare the short-term risks of the different methods.
The study is the largest of its kind. 1,735 adult patients facing surgery in the years 2015–2022 agreed to participate, and were randomly assigned to either gastric bypass or gastric sleeve. The operations were performed in university and other hospitals, public and private, of which 20 in Sweden and 3 in Norway.
Relatively few complications
The results, now presented in the journal JAMA Network Open, show no significant differences between the methods. The operating time was longer with gastric bypass, on average 68 minutes compared to 47 with the gastric sleeve, but the time in hospital after surgery was one day regardless of the method.
The follow-ups also gave equivalent results for the two methods. At 30 days after surgery, both groups had relatively few complications in the form of, for example, bleeding, leakage, blood clots and infections. No deaths occurred during the follow-up period of a total of 90 days.
– For both surgical methods, the complication risk is very low, especially from an international perspective, and there is no statistically significant or clinically relevant difference between the groups, says the study’s first author Suzanne Hedberg.
Many affected and many opinions
– Many people have undergone surgery, or are on the waiting list for surgery, and there are a lot of discussions and opinions about the various methods. What the study shows is that patients and doctors can now choose a surgical method without taking into account short-term surgical risks, she states.
Suzanne Hedberg has a doctorate in surgery at Sahlgrenska Academy at the University of Gothenburg and senior physician at Sahlgrenska University Hospital. The study, which is part of her thesis, is the first publication of results from BEST (Bypass Equipoise Sleeve Trial), a Scandinavian registry-supported randomized controlled multicenter trial comparing the two methods of bariatric surgery. The main outcome of the study, where the risk of complications and weight development over 5 years is analysed, is expected to be completed in 2028.
– For the further studies, we have had a good start, and equivalent groups that lay a good foundation for further comparisons of longer-term results, concludes Suzanne Hedberg.
Contact: Suzanne Hedberg, tel. 0709 71 00 41, e-post [email protected] – can be reached most securely via phone/text on Tuesday afternoon/evening, and via email on Wednesday.
Bild: Suzanne Hedberg (foto: Robert Lipic)
Margareta Gustafsson Cubist
Press responsible communicator
Sahlgrenska Academy at the University of Gothenburg
Tel. 0705 30 19 80
E-mail [email protected]
The Sahlgrenska Academy is Gothenburg University’s medical faculty with education and research in medicine, odontology and healthcare sciences, www.gu.se/sahlgrenska-akademin
