Obesity Disease and Surgery

Table 4

Procedure	Advantages	Disadvantages
Vertical banded gastroplasty	(i) No intestinal anastomosis	(i) Foreign body
	(ii) No malabsorption	(ii) High long-term failure rate
Adjustable gastric banding	(i) Technically simple	(i) Foreign body
	(ii) Low morbidity	(ii) 15–30% failure rate
	(iii) Reversible	(iii) May promote maladaptive eating behaviour
	(iv) No intestinal anastomosis
	(v) No malabsorption
Sleeve gastrectomy	(i) Technically simple	(i) May require second-stage procedure
	(ii) Low morbidity	(ii) Unknown long-term results
Gastric bypass	(i) Sustained weight loss	(i) Intestinal anastamoses
	(ii) Dumping in sweet eaters	(ii) Loss of access to gastric remnant
	(iii) Resolution of gastroesophageal; reflux disease	(iii) Mild risk for vitamin deficiencies
		(iv) Risk of marginal ulceration
Biliopancreatic diversion-duodenal switch	(i) Excellent sustained weight loss	(i) Technically demanding
	(ii) Larger portion size	(ii) Frequent bowel movement and flatulence
	(iii) Excellent malabsorption	(iii) Increased risk of vitamin and protein malnutrition