Gastric bypass favored weight loss; sleeve surgery had fewer late major complications
Long-term randomized trials found a tradeoff between greater weight loss after gastric bypass and fewer late major complications after sleeve surgery.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Gastric bypass produced greater long-term weight loss and more diabetes remission than sleeve surgery, while sleeve surgery had fewer late major complications. Reflux outcomes also favored bypass, although HbA1c levels were similar between groups. These findings show a tradeoff between measured benefits and harms rather than a universally preferable operation.
The abstract provides no absolute complication rates or enough patient detail to estimate individual benefits and harms. This summary is based on the abstract alone.
What researchers found
Late major complications
Sleeve versus bypass, with at least 5 years of follow-up: risk ratio 0.41 (95% confidence interval 0.20–0.85). Estimated sleeve risk was 0.41 times bypass risk; absolute event rates are unreported.
Benefits differed by outcome
Weight loss, diabetes remission and reflux control favored bypass. Diabetes remission and HbA1c are distinct outcomes, so higher remission should be considered alongside the similar HbA1c levels reported between groups.
Uncertain comparisons remain
Cholesterol disorders, high blood pressure, sleep apnea and joint pain showed no statistically significant differences. Neither did early complications or late minor complications. These findings do not establish that the procedures have equivalent effects.
The original publication
Long-Term Outcomes in Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis of Randomized Trials.
Monteiro Delgado L, Fabretina de Souza V, Fontel Pompeu B et al.
Obes Surg · 2025
- PubMed ID
- 40622470
- Record checked
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