Aim: The objective of this randomized, prospective study is to provide a critical appraisal comparing 
laparoscopic gastric banding versus laparoscopic sleeve gastrectomy in the treatment of morbidly obese 
patients.
Methods: The study involved 100 patients, in the period between May 2005 and November 2007. They were 
randomly assigned to: Group 1: 52 patients subjected to laparoscopic adjustable gastric band or Group 2: 48 
patients subjected to laparoscopic sleeve gastrectomy. 
Results: After 1 year of follow-up, there was a statistically significant difference between the two groups 
regarding the percentage of excess weight loss (%EWL) and the rate of complications (p<0.05). The %EWL 
was 63.6±5.4 in group 1 and 68.4±6.2 in group 2. Staple line leakage was reported in 2 cases (4.2%) and band 
erosion in 2 cases (3.8%).
After 3 years of follow-up, there was no significant difference between the two groups regarding the rate of 
complication, but there was a statistically significant difference between the 2 groups regarding the %EWL;
being 71.3±7.3 for patients in group 1 and 78.5±5.2 in group 2. Four patients (8.3%) in group 2 acquired 
pouch dilatation. Port site hernia developed in one patient (2.1%) in group 2. Insufficient weight loss noticed
in 2 patients (3.8%) in group 1 and in 2 patients (4.2%) in group 2, which was not statistically significant.
Conclusion: Sleeve gastrectomy is significantly more effective than gastric banding in terms of late 
complications, late reoperations, and long-term results on weight loss.