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Related Experiment Video

Updated: Jul 18, 2025

A Murine Model of Vertical Sleeve Gastrectomy
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Rates, Risks, and Time to Fracture in Patients Undergoing Laparoscopic Vertical Sleeve Gastrectomy versus Roux-en-Y

Syed I Khalid1,2, Kyle B Thomson3, Adan Z Becerra1

  • 1From the Department of Surgery, Rush University Medical Center, Chicago, IL.

Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches
|August 28, 2023
PubMed
Summary

Vertical sleeve gastrectomy (VSG) is associated with a lower risk of fractures compared to Roux-en-Y gastric bypass (RYGB). Postmenopausal or osteoporotic status increases fracture risk, regardless of the bariatric surgery type.

Keywords:
ObesityRoux-en-Ybariatric surgeryfracturegastric bypassmetabolic and bariatric surgeryvertical sleeve gastrectomy

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Area of Science:

  • Bariatric surgery outcomes
  • Skeletal health after weight loss surgery
  • Fracture risk assessment

Background:

  • Metabolic and bariatric surgery can lead to bone loss and increase fracture risk.
  • Preoperative factors influencing fracture risk and timing after surgery are not well-established.
  • Differences in fracture risk based on surgical approach (VSG vs. RYGB) are unknown.

Purpose of the Study:

  • To compare fracture incidence and time to fracture between laparoscopic vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB).
  • To identify patient characteristics associated with increased fracture risk after bariatric surgery.

Main Methods:

  • Population-based retrospective cohort analysis of 4073 patients undergoing primary laparoscopic RYGB or VSG.
  • Utilized insurance claims data from January 1, 2007, to March 31, 2017.
  • Primary outcomes: fracture incidence and time to fracture within 48 months post-surgery.

Main Results:

  • VSG was associated with reduced risk of total, vertebral, hip, and humeral fractures compared to RYGB.
  • Postmenopausal status and osteoporosis independently increased the odds of total and hip fractures.
  • RYGB was associated with a significantly reduced time to fracture in postmenopausal and osteoporotic patients.

Conclusions:

  • Bariatric surgery strategy impacts fracture risk, with RYGB posing a higher risk and shorter time to fracture.
  • Postmenopausal and osteoporotic status are significant risk factors for fractures post-bariatric surgery, irrespective of surgical approach.
  • Assessing patient-specific fracture risk is crucial for prevention and management after bariatric procedures.