Over the last decade, laparoscopic sleeve gastrectomy (SG) has surpassed Roux-en-Y Gastric Bypass (RYGB) in popularity. Previous studies have suggested lower rates of complications in SG; however, there are limited large-scale studies.


The 2015-2017 MBSAQIP Participant Use File was used to assess early postoperative differences between laparoscopic RYGB and SG in adults. Descriptive statistics, independent t-tests, and chi-squared tests were used to describe the sample. Multivariable logistic regression was used to assess 30-day outcomes.


467,444 cases met inclusion criteria. Patients who underwent RYGB were older (45.6 + 11.8 years vs. 44.5 + 12 years, p < 0.001), more likely to be white (n = 99,609, 75.3% p < 0.001), female (n = 106,943, 80.9% p < 0.001), and had higher body mass indexes (45.7 + 8.2 kg/m2 p < 0.001) and higher rates of most comorbidities (p <0.001). The majority of the growth in surgical volume over the three years was attributed to increases in SG (p <0.001). Across all three years, readmission, reoperation, intervention, and mortality odds ratios were all smaller in SG patients (p < 0.001). SG patients had lower odds of the three most common reasons for readmission, reoperation, and intervention (p < 0.001).


The rates of readmission, reoperation, intervention, and mortality in RYGB and SG have declined from 2015 to 2017, specifically in SG. Outcomes suggest SG is lower in risk profile and becoming increasingly popular over RYGB.