Laparoscopic Sleeve Gastrectomy versus Gastric Bypass in Late Adolescents: What Is the Optimal Surgical Strategy for Morbid Obesity?

Introduction  Interest in bariatric surgery in adolescents is increasing, because adolescent obesity equals increased health risks in adult life. To define the preferred procedure in adolescents, this study compares outcomes of LSG and LRYGB in late adolescents in our center. Materials and methods  Data on baseline characteristics, operative details, and follow-up were collected retrospectively in all patients (age 18–20 years) who underwent LSG or LRYGB in our clinic. Outcomes were analyzed using nonparametric tests. Results  Total 65 adolescents (54 females; median age 19 years) were included, 45 patients underwent LSG, and 20 underwent LRYGB. Significant differences in %EWL were observed at 2-year follow-up; 81.0% in LRYGB ( n  = 11) versus 96.8% in LSG ( n  = 23), p  = 0.007. No differences were observed in postoperative mortality, complication rate, and resolution of comorbidities between both procedures. Discussion  LSG showed significant better results than LRYGB in terms of %EWL after 2 years in this selected group of late adolescents. Considering these results in LSG patients and the theoretical advantages of LSG (normal diet options, preservation of an intact GI-tract, less vitamin disturbances, and better quality of life), LSG may be an appropriate bariatric technique to perform in morbidly obese adolescents.