Efficacy of Laparoscopic Greater Curvature Plication for Weight Loss and Type 2 Diabetes: 1-Year Follow-Up
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- Taha, O. OBES SURG (2012) 22: 1629. doi:10.1007/s11695-012-0724-y
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Laparoscopic greater curvature plication (LGCP) has gained popularity within the last 2 years because it is a restrictive procedure that reduces gastric volume without the need for stomach resection.
A prospective study was performed in which 55 morbidly obese patients with type 2 diabetes (44 female, 11 male) underwent LGCP. The patients had a mean age of 38.5 years (22–55 years), mean BMI of 43.5 kg/m2 (35–52 kg/m2), and mean glycosylated hemoglobin (HbA1c) of 7.9 % (6–10 %).
All procedures were completed laparoscopically. The mean operative time was 55 min (40–80 min), and the mean hospital stay was 1.8 days (1.5–5 days). No intraoperative or postoperative complications were reported apart from three cases of resistant nausea and vomiting and one case of intraluminal bleeding. The mean excess weight loss (EWL%) was 35 % (30–65 %) after 12 months with a mean BMI of 38 kg/m2 after 12 months. A total of 23 % of patients stopped losing weight 6 months after the procedure, and 11 % began regaining about 14 % (12–20 %) of their EWL 9 months after the procedure. The mean HbA1c was 7.5 % (5.5–8 %) after 12 months.
LGCP is feasible and safe in the short term when applied to morbidly obese patients, but may be unsustainable. It is inferior as a restrictive procedure for resolution of type 2 diabetes. Longer follow-up and prospective comparative trials are needed to clarify whether it can be considered an effective single-stage procedure for treating morbidly obese diabetic patients and their comorbidities.