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January 16, 2018

Comparing the Outcomes of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass for Severe Obesity

Author Affiliations
  • 1Kaiser Permanente Washington Health Research Institute, Seattle
  • 2Department of Medicine, University of Washington, Seattle
  • 3Bariatric Surgery Program, Washington Permanente Medical Group, Seattle
JAMA. 2018;319(3):235-237. doi:10.1001/jama.2017.20449

Over the past decade there has been a rapid shift in bariatric procedure use worldwide, with the sleeve gastrectomy replacing the Roux-en-Y gastric bypass as the procedure of choice in most patients with severe obesity. The sleeve gastrectomy is less technically complex than the bypass procedure, and involves a 70% vertical gastric resection with no intestinal bypass. The use of the sleeve gastrectomy was spurred by short-term evidence suggesting that weight loss was nearly equivalent to bypass, while conferring a lower risk of perioperative complications.1 However, the popularity of sleeve gastrectomy has outpaced data from rigorous comparative effectiveness research studies, and the durability and long-term safety of sleeve gastrectomy vs bypass remain topics of debate.

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