Indications for Sleeve Gastrectomy as a Primary Procedure for Weight Loss in the Morbidly Obese
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Single-stage laparoscopic sleeve gastrectomy (LSG) may represent an additional surgical option for morbid obesity.
We performed a retrospective review of a prospectively maintained database of LSG performed from November 2004 to April 2007 as a one-stage primary restrictive procedure.
One hundred forty-eight LSGs were performed as primary procedures for weight loss. The mean patient age was 42 years (range, 13–79), mean body mass index of 43.4 kg/m2 (range, 35–75), mean operative time of 60 min (range, 58–190), and mean blood loss of 60 ml (range, 0–300). One hundred forty-seven procedures (99.3%) were completed laparoscopically, with a mean hospital stay of 2.7 days (range, 2–25). A 2.7% major complication rate was observed with four events in three patients and no deaths. Four patients required readmission; mild dehydration in two, choledocholithiasis in one, and a gastric sleeve stricture in one.
Laparoscopic SG is a safe one-stage restrictive technique as a primary procedure for weight loss in the morbidly obese with an acceptable operative time, intraoperative blood loss, and perioperative complication rate.
KeywordsBariatric surgery Laparoscopy Morbid obesity Roux-en-Y-gastric bypass Sleeve gastrectomy
biliopancreatic diversion with duodenal switch
body mass index
laparoscopic adjustable gastric banding
laparoscopic Roux-en-Y gastric bypass
laparoscopic sleeve gastrectomy
Competing Interests Declared: None
- 2.DeMaria EJ, Schauer P, Patterson E, Nguyen NT, Jacob BP, Inabnet WB, Buchwald H. The optimal surgical management of the super-obese patient: the debate. Presented at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons, Hollywood, FL, USA, April 13–16, 2005. Surg Innov 2005;12(2):107–121.PubMedCrossRefGoogle Scholar
- 20.National Institutes of Health. Gastrointestinal surgery for severe obesity. NIH Consens Statement 1991;9(1):1–20.Google Scholar
- 22.Kotidis EV, Koliakos G, Papavramidis TS, Papavramidis ST. The effect of biliopancreatic diversion with pylorus-preserving sleeve gastrectomy and duodenal switch on fasting serum ghrelin, leptin and adiponectin levels: is there a hormonal contribution to the weight-reducing effect of this procedure? Obes Surg 2006;16(5):554–559.PubMedCrossRefGoogle Scholar
- 25.Silecchia G, Boru C, Pecchia A, Rizzello M, Casella G, Leonetti F, Basso N. 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(9):1138–1144.PubMedCrossRefGoogle Scholar