Bariatric surgical techniques have since evolved, and each reshapes the gastrointestinal system, and potentially alcohol pharmacokinetics in distinct ways. Sleeve gastrectomy (SG) now accounts for 72% of US bariatric surgeries (243). It removes about 80–85% of the stomach but preserves the pylorus (Figure 10). Roux-en-Y gastric bypass surgery (RYGB), the second most common procedure at 21%, creates a small gastric pouch (~30 ml) connected to the distal jejunum. Laparoscopic gastric banding (LAGB), once common (44% in 2008), now represents less than 1% of surgeries due to poor long-term outcomes. In LAGB, a small adjustable silicone band is placed around the upper stomach. This creates a narrowed passage between the upper and lower parts of the stomach and limits how much food a person can eat at one time.
