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Laparoscopic sleeve gastrectomy: Complications and short-term results

  • Retrospective Observational Study
  • Published:
Hellenic Journal of Surgery

Abstract

Background

In recent years, laparoscopic sleeve gastrectomy has become one of the most frequently performed bariatric operations in Europe. This procedure can be used as a stand-alone procedure for the treatment of malignant obesity or as a first step in an attempt to accomplish a massive weight reduction. This retrospective study evaluated the complications and 3-year results obtained in patients that underwent laparoscopic sleeve gastrectomy.

Methods

A total of 178 patients were included in this retrospective study. Patients fulfilled the inclusion criteria and were all informed of the probable complications. All patients were operated on laparoscopically by applying a standardized surgical technique.

Results

The mean operative time was 72 minutes. No surgical bleeding occurred within the peritoneal cavity. No clinical leaks were identified intraoperatively using the saline submersion test. The percentage of excess weight loss ranged from 21.85% to 75.47% in the follow-up period. Complications were categorized as minor and major, and included haemorrhage, abscess, fluid collection and leakage. Ten re-operations and three deaths were reported.

Conclusion

Results from this series of patients indicate laparoscopic sleeve gastrectomy to be relatively safe, reproducible, and efficacious as a stand-alone bariatric procedure in achieving and maintaining weight loss in short-term follow-up. However, the disadvantages of the procedure, such as its irreversibility and its major complications, place under discussion the common practice and necessary prerequisites for thorough patient update and consent.

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Abbreviations

LSG:

laparoscopic sleeve gastrectomy

LAGB:

laparoscopic adjustable gastric banding

BPD-DS:

biliopancreatic diversion and duodenal switch

LRYGBP:

laparoscopic Roux-en-Y gastric bypass

BMI:

body mass index

%BMI:

percentage of body mass index

PACU:

postanaesthesia care unit

TWL:

total weight loss

EWL:

excess weight loss

%EWL:

percentage of excess weight loss

EBMIL:

excess of body mass index loss

%EBMIL:

percentage of excess body mass index loss

BWL:

initial body weight loss

%BWL:

percentage of initial body weight loss

IBW:

ideal body weight

LOS:

length of hospital stay

ICU:

intensive care unit

References

  1. Burns EM, Naseem H, Bottle A, et al. Introduction of laparoscopic bariatric surgery in England: observational population cohort study. BMJ 2010;341:c4296.

    Article  PubMed  Google Scholar 

  2. Lee SY, Lim CH, Pasupathy S, et al. Laparoscopic sleeve gastrectomy: a novel procedure for weight loss. Singapore Med J 2011;52:794.

    CAS  PubMed  Google Scholar 

  3. Nath A, LeBlanc KA, Hausmann MG, K Kleinpeter, Allain BW, Roderick Romero. Laparoscopic Sleeve Gastrectomy: Our First 100 Patients. JSLS 2010;14:502–8

    Article  PubMed Central  PubMed  Google Scholar 

  4. Lalor PF, Tucker ON, Rosenthal RJ, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 2008;4:33–8.

    Article  PubMed  Google Scholar 

  5. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005;15:1024–9.

    Article  CAS  PubMed  Google Scholar 

  6. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg 2008;247:401–7.

    Article  PubMed  Google Scholar 

  7. Silecchia GF, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg 2006;16:1138–44.

    Article  PubMed  Google Scholar 

  8. Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg 2008;18:560–5.

    Article  CAS  PubMed  Google Scholar 

  9. Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg 2007;17:962–9.

    Article  PubMed  Google Scholar 

  10. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis 2009;5:469–75.

    Article  PubMed  Google Scholar 

  11. Adrianus C, Berende S, de Zoete J-P, Smulders J-F, Willem S. Laparoscopic Sleeve Gastrectomy Feasible for Bariatric Revision Surgery. Nienhuijs Obes Surg 2012;22:330–4.

    Article  Google Scholar 

  12. Consten EC, Gagner M, Pomp A, Inabnet WB. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg 2004;14:1360–6.

    Article  PubMed  Google Scholar 

  13. Iannelli A, Dainese R, Piche T, Facchiano E, Gugenheim J. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol 2008;14:821–7.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Esteban Varela J. Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Adjustable Gastric Banding for the Treatment of Severe Obesity in High Risk Patients. JSLS 2011;15:486–91.

    Article  PubMed  Google Scholar 

  15. Runkel N, Colombo-Benkmann M, Huttl TP, Tiggers H, Mass O, Sauerland S. Dtsch Bariatric Surgery. Arztebl Int. 2011;108:341–6.

    Google Scholar 

  16. World Health Organization. World Health Report 2002. Available at: www.who.int/whr/2002/en/whr02_en.pdf. Accessed January 13, 2004.

  17. Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA 1999; 282:1523–9.

    Article  CAS  PubMed  Google Scholar 

  18. Overweight, obesity, and health risk. National Task Force on the Prevention and Treatment of Obesity. Arch Intern Med 2000;160:898–904.

  19. Klein S, Sheard NF, Pi-Sunyer X, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr 2004;80:257–63.

    CAS  PubMed  Google Scholar 

  20. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. NIH conference. Ann Intern Med 1991;115:956–61.

  21. Gluck B, Movitz B, Jansma S, Gluck J, Laskowski K. Laparoscopic Sleeve Gastrectomy is a Safe and Effective Bariatric Procedure for the Lower BMI (35.0-43.0 kg/m2) Population. Obes Surg 2011;21:1168–71.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic divrsion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 2000;10:514–23; Discussion 524.

    Article  CAS  PubMed  Google Scholar 

  23. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003;13:861–4.

    Article  CAS  PubMed  Google Scholar 

  24. Baltasar A, Serra C, Perez N, Bou R, Bengochea M, Ferri L. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.

    Article  PubMed  Google Scholar 

  25. Behrens C, Tang BQ, Amson BJ. Early results of a Canadian laparoscopic sleeve gastrectomy experience. Can J Surg 2011;54:138–43.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Gentileschi P. Laparoscopic sleeve gastrectomy as a primary operation for morbid obesity: experience with 200 patients. Gastroenterol Res Pract 2012;2012:801325.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Fuks D, Verhaeghe P, Brehant O, et al. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery 2009;145:106–13

    Article  PubMed  Google Scholar 

  28. Demaria EJ, Winegar DA, Pate VW, Hutcher NE, Ponce J, Pories WJ. Early postoperative outcomes of metabolic surgery to treat diabetes from sites participating in the ASMBS Bariatric Surgery Center of Excellence Program as reported in the Bariatric Outcomes Longitudinal Database. Ann Surg 2010;252:559–66.

    PubMed  Google Scholar 

  29. Acholonu E, McBean E, Rosenthal RJ, et al. Safety and short-term outcomes of laparoscopic sleeve gastrectomy as a revisional approach for failed laparoscopic adjustable gastric banding in the treatment of morbid obesity. Obes Surg 2009;19:1612–6.

    Article  PubMed  Google Scholar 

  30. Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, Oct 25–27 2007. Obes Surg 2008;18:487–96.

    Article  PubMed  Google Scholar 

  31. Pories WJ, Dohm LG, Mansfield CJ. Beyond the BMI: the search for better guidelines for bariatric surgery. Obesity (Silver Spring) 2010;18:865–71.

    Article  PubMed  Google Scholar 

  32. Schoeder R, Garrison JM, MS Johnson. Treatment of Adult Obesity with Bariatric Surgery. Am Fam Physician 2011;84:805–14.

    Google Scholar 

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Author information

Authors and Affiliations

  1. 3rd Surgical Department of University Hospital of “Attikon”, Athens, Greece

    Sylvia Krivan

  2. Digestive and Bariatric Surgery Department at “IATRIKO ATHINON”, Athens, Greece

    George Spiliopoulos

  3. University of Athens, Athens, Greece

    Christos P. Tsigris

  4. Onassis Cardiac Surgery Centre, Department of Surgery at Euroclinic Group, University of Athens, Athens, Greece

    Nikolaos I. Nikiteas

Authors
  1. Sylvia Krivan
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  2. George Spiliopoulos
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  3. Christos P. Tsigris
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  4. Nikolaos I. Nikiteas
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Correspondence to Sylvia Krivan.

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Krivan, S., Spiliopoulos, G., Tsigris, C.P. et al. Laparoscopic sleeve gastrectomy: Complications and short-term results. Hellenic J Surg 87, 357–363 (2015). https://doi.org/10.1007/s13126-015-0241-2

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  • DOI: https://doi.org/10.1007/s13126-015-0241-2

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