Surgical Endoscopy

, Volume 27, Issue 8, pp 2768–2774 | Cite as

Comparison of short-term outcomes between laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy

  • Dijian Shen
  • Huan Ye
  • Yuedong Wang
  • Yun Ji
  • Xiaoli Zhan
  • Jinhui Zhu
  • Wei Li



Laparoscopic greater curvature plication (LGCP) is an emerging restrictive bariatric procedure that successfully reduces the gastric volume by plication of the gastric greater curvature. The aim of this prospective nonrandomized study was to compare short-term outcomes and associated complications between LGCP and laparoscopic sleeve gastrectomy (LSG).


From January 2011 to November 2011, a total of 39 patients were allocated to undergo either LGCP (n = 19) or LSG (n = 20). Data on the operative time, complications, hospital stay, overall cost of LSG and LGCP, body mass index loss (BMIL), percentage of excess weight loss (%EWL), loss of appetite and improvement of comorbidities were collected during the follow-up examinations.


All procedures were completed laparoscopically. The mean operative time was 95.0 ± 17.4 minutes for the LGCP group and 85.5 ± 18.4 minutes for the LSG group (P = 0.107). No patient required reoperation due to an early complication. One patient in the LSG group was readmitted because of gastric stenosis. The mean hospital stay was 4.2 ± 1.9 days in the LGCP group and 3.9 ± 1.7 days in the LSG group (P = 0.595). The total cost of LSG was $7,826 ± 537 compared to LGCP ($3,358 ± 264) (P < 0.001). One year after surgery, the mean %EWL was 58.8 ± 16.7 % (n = 11) in the LGCP group and 80.0 ± 26.8 % (n = 11) in the LSG group (P = 0.038). Loss of feeling of hunger was reported in 27.3 % LGCP patients and 72.7 % LSG patients (P = 0.033) at 1 year after surgery. The comorbidities, including diabetes, sleep apnea and hypertension, were markedly improved in both groups 6 months after surgery.


The short-term outcomes of our study demonstrate that compared with LSG, LGCP is inferior as a restrictive procedure for weight loss, despite its significantly smaller cost. Longer follow-up and prospective comparative trials are needed to confirm the long-term outcomes of this novel procedure and make definitive conclusions.


Bariatric Greater curvature plication Laparoscopy Obesity Sleeve gastrectomy 



Supported in part by the Science Research Foundation of the National Health Ministry and Zhejiang Health Bureau of China (Grant WKJ 2011-2-013).


Dijian Shen, Huan Ye, Yuedong Wang, Yun Ji, Xiaoli Zhan, Jinhui Zhu and Wei Li have no conflicts of interest or financial ties to disclose.


  1. 1.
    Wang Y, Mi J, Shan XY, Wang QJ, Ge KY (2007) Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond) 31:177–188CrossRefGoogle Scholar
  2. 2.
    Colquitt JL, Picot J, Loveman E, Clegg AJ (2009) Surgery for obesity. Cochrane Database Syst Rev (2):CD003641Google Scholar
  3. 3.
    Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 13:861–864PubMedCrossRefGoogle Scholar
  4. 4.
    Himpens J, Dobbeleir J, Peeters G (2010) Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 252:319–324PubMedCrossRefGoogle Scholar
  5. 5.
    Silecchia G, Boru C, Pecchia A, Rizzello M, Casella G, Leonetti F, Basso N (2006) Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg 16:1138–1144PubMedCrossRefGoogle Scholar
  6. 6.
    Shi X, Karmali S, Sharma AM, Birch DW (2010) A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 20:1171–1177PubMedCrossRefGoogle Scholar
  7. 7.
    Campos JM, Siqueira LT, Meira MR, Ferraz AA, Ferraz EM, Guimaraes MJ (2007) Gastrobronchial fistula as a rare complication of gastroplasty for obesity: a report of two cases. J Bras Pneumol 33:475–479PubMedCrossRefGoogle Scholar
  8. 8.
    Casella G, Soricelli E, Rizzello M, Trentino P, Fiocca F, Fantini A, Salvatori FM, Basso N (2009) Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obes Surg 19:821–826PubMedCrossRefGoogle Scholar
  9. 9.
    Ramos A, Galvao Neto M, Galvao M, Evangelista LF, Campos JM, Ferraz A (2010) Laparoscopic greater curvature plication: initial results of an alternative restrictive bariatric procedure. Obes Surg 20:913–918PubMedCrossRefGoogle Scholar
  10. 10.
    Skrekas G, Antiochos K, Stafyla VK (2011) Laparoscopic gastric greater curvature plication: results and complications in a series of 135 patients. Obes Surg 21:1657–1663PubMedCrossRefGoogle Scholar
  11. 11.
    Fried M, Dolezalova K, Buchwald JN, McGlennon TW, Sramkova P, Ribaric G (2012) Laparoscopic greater curvature plication (LGCP) for treatment of morbid obesity in a series of 244 patients. Obes Surg 22:1298–1307PubMedCrossRefGoogle Scholar
  12. 12.
    Brethauer SA, Harris JL, Kroh M, Schauer PR (2011) Laparoscopic gastric plication for treatment of severe obesity. Surg Obes Relat Dis 7:15–22PubMedCrossRefGoogle Scholar
  13. 13.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737PubMedCrossRefGoogle Scholar
  14. 14.
    Inui A, Asakawa A, Bowers CY, Mantovani G, Laviano A, Meguid MM, Fujimiya M (2004) Ghrelin, appetite, and gastric motility: the emerging role of the stomach as an endocrine organ. FASEB J 18:439–456PubMedCrossRefGoogle Scholar
  15. 15.
    Date Y, Kojima M, Hosoda H, Sawaguchi A, Mondal MS, Suganuma T, Matsukura S, Kangawa K, Nakazato M (2000) Ghrelin, a novel growth hormone-releasing acylated peptide, is synthesized in a distinct endocrine cell type in the gastrointestinal tracts of rats and humans. Endocrinology 141:4255–4261PubMedCrossRefGoogle Scholar
  16. 16.
    Cummings DE (2006) Ghrelin and the short- and long-term regulation of appetite and body weight. Physiol Behav 89:71–84PubMedCrossRefGoogle Scholar
  17. 17.
    Kirchner H, Heppner KM, Tschop MH (2012) The role of ghrelin in the control of energy balance. Handb Exp Pharmacol 209:161–184PubMedCrossRefGoogle Scholar
  18. 18.
    Langer FB, Reza Hoda MA, Bohdjalian A, Felberbauer FX, Zacherl J, Wenzl E, Schindler K, Luger A, Ludvik B, Prager G (2005) Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 15:1024–1029PubMedCrossRefGoogle Scholar
  19. 19.
    Wu J, Ye H, Wang Y, Zhu Y, Xie Z, Zhan X (2012) Comparative study of laparoscopic sleeve gastrectomy with and without partial enterectomy and omentectomy. Surg Obes Relat Dis 8:275–280PubMedCrossRefGoogle Scholar
  20. 20.
    Harvey EJ, Arroyo K, Korner J, Inabnet WB (2010) Hormone changes affecting energy homeostasis after metabolic surgery. Mt Sinai J Med 77:446–465PubMedCrossRefGoogle Scholar
  21. 21.
    Stanhope KL, Schwarz JM, Keim NL, Griffen SC, Bremer AA, Graham JL, Hatcher B, Cox CL, Dyachenko A, Zhang W, McGahan JP, Seibert A, Krauss RM, Chiu S, Schaefer EJ, Ai M, Otokozawa S, Nakajima K, Nakano T, Beysen C, Hellerstein MK, Berglund L, Havel PJ (2009) Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest 119:1322–1334PubMedCrossRefGoogle Scholar
  22. 22.
    Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Leccesi L, Nanni G, Pomp A, Castagneto M, Ghirlanda G, Rubino F (2012) Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med 366:1577–1585PubMedCrossRefGoogle Scholar
  23. 23.
    Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, Thomas S, Abood B, Nissen SE, Bhatt DL (2012) Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 366:1567–1576PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Dijian Shen
    • 1
  • Huan Ye
    • 2
  • Yuedong Wang
    • 1
  • Yun Ji
    • 1
  • Xiaoli Zhan
    • 1
  • Jinhui Zhu
    • 1
  • Wei Li
    • 1
  1. 1.Department of General SurgerySecond Affiliated Hospital Zhejiang University College of MedicineHangzhouChina
  2. 2.Clinical Medical SchoolHangzhou Normal UniversityHangzhouChina

Personalised recommendations