Sleeve Gastrectomy With Transit Bipartition(SG+TB) Versus Roux-en-Y Gastric Bypass (RYGB) for Type 3 Obesity

Inclusion Criteria:

• Patient who has benefited from a pluridisciplinary evaluation, with a favorableopinion for SG+TB or RYGB as a first intention procedure with BMI ≥40 kg/m2 or BMI ≥ 35 kg/m2 associated with one co-morbidity which will be improved by surgery (accordingto HAS 2009 recommendation3) OR as a second intention procedure (revisional surgery)after failure of Sleeve gastrectomy (defined as insufficient weight loss at 18 monthsafter surgery (EWL% <50), or as weight regain (+ 20%)).
• Patient who had benefited from an Upper GI Endoscopy with biopsies to look forHelicobacter Pylori (HP) and a HP eradication.
• Patient who understands and accepts the need for a long-term follow-up
• Patient who agrees to be included in the study and who signs the informed consent form
• Patient affiliated to a healthcare insurance plan

Exclusion Criteria:

• History of previous bariatric surgery, other than a Sleeve Gastrectomy
• Patient with current BMI > 60 kg/m2
• Presence of a severe and evolutive life threatening pathology, unrelated to obesity
• History of Chronic inflammatory bowel disease
• Type 1 Diabetes
• Pregnancy or desire to be pregnant during the study
• Nursing woman
• Presence of Pylori Helicobacter resistant to medical treatment
• Presence of a non-healed gastro-duodenal ulcer or diagnosed less than 2 monthspreviously
• Severe esophagitis (grade C of Los Angeles classification)
• Hiatal hernia
• Patients with unstable psychiatric disorder, under supervision or guardianship
• Patient who does not understand French/ is unable to give consent
• Patient not affiliated to a French or European healthcare insurance
• Patient who has already been included in a trial which has a conflict of interestswith the present study
• Patient incarcerated