BariClip, another surgical treatment of obesity - can it compete with sleeve gastrectomy?

<b>Introduction:</b> Surgical treatment of obesity is a recognized method of treatment for this disease. There are several surgical methods used, but there is no silver bullet, as relapses and side effects occur after virtually every procedure.<b>Aim:</b> Vertical gastric banding, also known as BariClip implantation (Laparoscopic BariClip Gastroplasty [LBCG]), is not a popular surgical procedure in Poland; it is anatomically similar to LSG (Laparoscopic Sleeve Gastrectomy). The aim of this study was to assess weight loss following LSG and LBCG, as well as the incidence of one of the most common complications following sleeve gastrectomy: gastro-oesophageal reflux.<b>Material and methods:</b> As many as 110 patients were analyzed who underwent surgery between September 2022 and September 2023 in this group - 55 BariClip and 55 LSG. Patients were assessed after ten days /removal of sutures/, after one month, after six months, and after one year. Statistical analysis of the data was performed using descriptive and analytical statistics. Statistical significance of differences was assessed with the Student's t-test, and, when the assumption of a normal distribution was not met, with the non-parametric Mann-Whitney U test. The association between the incidence of postoperative reflux and the type of surgery was assessed using Pearson's Chi-square correlation tests.<b>Results:</b> In the early postoperative period, there was no statistically significant difference in weight loss between the LSG and LBCG groups. Only the weight loss at twelve months postoperatively was statistically significant (p<0.001). Gastroesophageal reflux was significantly more common in patients undergoing sleeve gastrectomy compared to those undergoing LBCG. In patients after sleeve gastrectomy, the risk of gastro-oesophageal reflux is 3.4 (CI 95% 1.20-9.37; p = 0.02) times higher at three months after surgery, 15.5 (CI 95% 4.33-55.81; p<0.001) times higher at six months after surgery, and up to 17.7 (CI 95% 5.62-56.03; p<0.001) times higher at six months after surgery compared to patients after LBCG surgery.<b>Conclusions:</b> The study groups (LSG <i>vs.</i> LBCG) showed weight reduction at comparable levels at up to 6 months. In contrast, after 12 months, a significant difference in weight reduction of 4.6 kg was observed after LSG. LBCG does not cause GERD, which is one of the most common complications after LSG; in the material presented here, the risk of GERD after LSG was shown to be 15.5 times higher than after LBCG at six-month follow-up, and at one-year follow-up, 17.7 times higher than after LBCG.