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Long-term Effects of Laparoscopic Sleeve Gastrectomy: What Are the Results Beyond 10 Years?

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A Correction to this article was published on 10 May 2021

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Abstract

Purpose

Laparoscopic sleeve gastrectomy (LSG) has become the most commonly performed bariatric procedure worldwide. Newer studies providing long-term follow-up show a high incidence of weight regain and a high incidence of reflux. The study’s objective was to present 5 to 15-year follow-up results regarding weight loss, comorbidities, reoperation rate, and a potential learning curve.

Methods

This is a retrospective analysis of prospectively collected data. Patients who underwent LSG between August 2004 and December 2014 were included.

Results

A total of 307 patients underwent LSG either as a primary bariatric procedure (n = 262) or as a redo operation after failed laparoscopic gastric banding (n = 45). Mean body mass index at the time of primary LSG was 46.4 ± 8.0 kg/m2, and mean age at operation was 43.7 ± 12.4 years with 68% females. Follow-up was 84% and 70% at 5 and 10 years, respectively. The mean percentage excess body mass index loss (%EBMIL) for primary LSG was 62.8 ± 23.1% after 5 years, 53.6 ± 24.6% after 10 years, and 51.2 ± 20.3% after 13 years. Comorbidities improved considerably (e.g., type 2 diabetes mellitus 61%), while the incidence of new-onset reflux was 32.4%. Reoperation after LSG was necessary in almost every fifth LSG-patient: 24 patients (7.8%) were reoperated due to insufficient weight loss, 12 patients (3.9%) due to reflux, 23 due to both (7.5%).

Conclusions

LSG provides a long-term %EBMIL from 51 to 54% beyond 10 years and a significant improvement of comorbidities. On the other hand, a high incidence of insufficient weight loss and de novo reflux was observed, leading to reoperation and conversion to a different anatomy in 19.2%.

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Author notes

  1. Marko Kraljević and Vanessa Cordasco contributed equally to this work.

Authors and Affiliations

  1. Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, 4002, Basel, Switzerland

    Marko Kraljević, Romano Schneider & Ralph Peterli

  2. Naomi Berrie Diabetes Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Marko Kraljević

  3. Metabolic Research, St. Clara Research Ltd., Kleinriehenstrasse, 30 4058, Basel, Switzerland

    Vanessa Cordasco & Bettina Wölnerhanssen

  4. Interdisciplinary Center of Nutritional and Metabolic Diseases, St. Claraspital, Kleinriehenstrasse, 30 4058, Basel, Switzerland

    Thomas Peters & Marc Slawik

Authors
  1. Marko Kraljević
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  2. Vanessa Cordasco
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  3. Romano Schneider
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  4. Thomas Peters
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  5. Marc Slawik
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  6. Bettina Wölnerhanssen
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  7. Ralph Peterli
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Corresponding author

Correspondence to Marko Kraljević.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent does not apply as this is a database analysis.

Conflict of Interest

MK, VS, TP, MS, and BW declare no competing interests. RS reports grants from the University of Basel, grants from University Hospital Basel, Department of Surgery, grants from SFCS, grants from Gebauer Stiftung, and grants from Freiwillige Akademische Gesellschaft Basel, outside the submitted work. RP reports grants and personal fees from Ethicon Endo-Surgery, outside the submitted work.

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Keypoints

A retrospective study of 307 obese patients who underwent LSG as a primary or revisional procedure

LSG provides a mean %EBMIL from 51 to 54% beyond 10 years and a significant improvement of comorbidities.

The incidence of de novo reflux after LSG was 32.4% in the long-term.

Reoperation and conversion from LSG to different anatomy was necessary in almost every fifth patients.

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Kraljević, M., Cordasco, V., Schneider, R. et al. Long-term Effects of Laparoscopic Sleeve Gastrectomy: What Are the Results Beyond 10 Years?. OBES SURG 31, 3427–3433 (2021). https://doi.org/10.1007/s11695-021-05437-3

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  • DOI: https://doi.org/10.1007/s11695-021-05437-3

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