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Banded sleeve gastrectomy outperforms standard LSG but has higher incidence of post-op regurgitation symptoms

Laparoscopic banded sleeve gastrectomy (LBSG) showed a substantial decrease in BMI at three-year follow-up and higher %EWL at one, two and three year time points, according to a systematic review and meta-analysis by researchers from the Middle East. However, LBSG procedures exhibited a higher incidence of post-operative regurgitation symptoms than standard LSG.

The meta-analysis identified fifteen included studies including 3,929 patients. Of the studies, seven were conducted in Egypt, four in Germany, two in Italy and the remaining in India and Belgium. The study reported that 3,122 patients had LSG, while 807 had LBSG.

At six months, BMI was estimated only in four studies encompassing 451 patients with no substantial difference between LBSG and LSG groups. However, at 12 months, BMI was compared in five studies, including 1,862 patients, with no substantial difference between the two groups (p=0.13). Similarly, four studies including 1,771 patients at 24 months observed no substantial difference between LBSG and LSG groups (p=0.17).

Excess weight loss at 24 months (six studies - 2,007 patients) showed substantially higher %EWL in the LBSG group than the other group (p=0.003). EWL after 36 months was reported in four studies involving 478 patients and showed that the LBSG group had substantially greater %EWL than LSG (p=<0.00001).

Additional findings included:

  • Post-operative overall complications were studied in four studies totalling 2,088 participants - the results showed insignificant differences between LBSG and LSG (p=0.22).

  • Regarding early complications, LBSG did not substantially differ from LSG; (p=0.48). Six hundred-seven patients in five studies reported post-operative bleeding, a statistically insignificant difference between LBSG and LSG groups (p=0.57).

  • Post-operative reflux symptoms was evaluated in seven studies encompassing 633 patients with statistically insignificant differences between the compared interventions (p=0.98).

  • Four studies, including 421 patients, evaluated post-operative regurgitation; this analysis showed substantially higher regurgitation symptoms in the LBSG group vs LSG (p=0.008).

“Our study represents an updated evaluation of the comparative efficacy between banded and non-banded LSG, featuring a larger sample size and an extended follow-up duration of up to three years, allowing for a more comprehensive assessment of outcomes,” the authors concluded. “Further high-quality studies should address the limitations mentioned in our study, emphasizing larger sample sizes, uniform study designs and extended follow-ups to evaluate outcomes in banded versus non-banded LSG comprehensively.”

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