Broad acceptance of bariatric surgery stands on its durability. The durability of bariatric surgery at and beyond 10 years was examined in a systematic review and meta-analysis and a single-centre study of laparoscopic adjustable gastric banding (LAGB) with 20 years of follow-up

The systematic review with meta-analysis included all eligble reports containing 10 or more years of follow-up data on weight loss after bariatric surgery. Additionally, a prospective cohort study of LAGB patients with weight loss and reoperation at up to 20 years was included. 57 datasets were identified for Systematic review, 33 of which qualified for meta-analysis. There were 18 reports of gastric bypass, 17 reports of LAGB, 9 reports of biliopancreatic bypass ± duodenal switch and 2 reports of sleeve gastrectomy showed a weighted mean of 56.7% excess weight loss, showed 45.9%EWL, 74.1%EWL, 58.3%EWL respectively.

Comparable results were found by meta-analyses. Reoperations found their place in all groups. 

A single centre that followed up 8378 LAGB patients for up to 20 years with an overall follow-up rate of 54% reported no surgical deaths.

Weight loss at 20 years was reported to be 30.1 kg, 48.9%EWL and 22.2% total weight loss (%TWL).

The reoperation rate was found to be initially higher, but with improved band and surgical and aftercare techniques, the reoperation rate decreased.

Thus all current procedures were rendered to be associated with substantial and durable weight loss. The researchers warranted the need for more long-term data for one-anastomosis gastric bypass and sleeve gastrectomy, further mentioning the reoperation to be a common finding across all procedures.

O’Brien PE, e tal. Obes Surg. 2019;29(1):3-14.