Diabetes improvement and bariatric surgery—review of laparoscopic Roux-en-Y gastric bypass vs. laparoscopic vertical sleeve gastrectomy

Obesity and type 2 diabetes mellitus (T2DM) are globally escalating major health care issues. For both obesity and T2DM management, it has been well established that bariatric surgery is superior to lifestyle and medical management alone. Over the past two decades, the introduction of laparoscopic vertical sleeve gastrectomy (LVSG) has seen a marked rise in usage, and combined with laparoscopic Roux-en-Y gastric bypass (LRYGB), these two procedures represent more than 80% of all bariatric surgeries globally. However, the differences in effectiveness between these two procedures have been less clearly defined. This article will serve as a focused review of the literature comparing LRYGB and LVSG for T2DM management. Based on our review, we believe that both procedures are very effective at improving T2DM care, especially compared with conventional medical management. However, there may be a modest benefit to be had by using LRYGB over LVSG.