Impact of laparoscopic Roux-en-Y Gastric bypass versus sleeve gastrectomy on postoperative lipid values.

BACKGROUND: Metabolic surgery has been shown to significantly improve many obesity-related co-morbidities, including dyslipidemia. The literature has produced mixed results comparing postoperative lipid values after laparoscopic Roux-en-Y gastric bypass (LRYGB) compared to laparoscopic sleeve gastrectomy (LSG); with some indicating significantly greater reductions in total cholesterol and low-density lipoprotein (LDL) in LRYGB versus LSG, and others reporting no significant differences. OBJECTIVES: To evaluate the postoperative lipid values after LRYGB versus LSG at a community hospital. SETTING: Integrated multispecialty health system with a community teaching hospital. METHODS: A retrospective review of our prospective database was completed to identify patients who underwent either LRYGB or LSG at our institution from 2001 through 2013. Lipid values available at 6-18 months postoperative were evaluated. Statistical analysis included χ2 and Wilcoxon rank-sum tests. A P value<.05 was considered significant. RESULTS: There were 1326 and 121 patients who underwent LRYGB and LSG during the study period, respectively. Of these patients, 644 LRYGB and 67 LSG patients had pre- and postoperative lipid values available and included in the final analysis. Postoperative mean total cholesterol and LDL values were significantly lower in LYRGB versus LSG patients. Postoperatively, 10% and 30% of LRYGB and LSG patients had a total cholesterol values≥200 mg/dL (P<.001); 4% and 24% had LDL values≥130 mg/dL (P<.001); and 8% and 9% had triglyceride levels>130 mg/dL (P = .68), respectively. HDL values were within the recommended range in 52% and 57% of LRYGB and LSG patients, respectively (P = .64). CONCLUSION: Patients who underwent LRYGB had a greater postoperative reduction in total cholesterol, LDL, and triglycerides. LRYGB may be the more appropriate bariatric procedure for patients with significant preoperative hypercholesterolemia.