Outcomes of bariatric surgery for Japanese patients

Hirofumi Imoto, MD, PhD, Takeshi Naitoh, MD, PhD, FACS, Naoki Tanaka, MD, PhD, Munenori Nagao, MD, PhD, Kazuhiro Watanabe, MD, PhD, Tomoya Abe, MD, PhD, Shinobu Ohnuma, MD, PhD, Katsuyoshi Kudo, MD, PhD, Takeshi Aoki, MD, PhD, Hiedaki Karasawa, MD, PhD, Takahiro Tsuchiya, MD, PhD, Fuyuhiko Motoi, MD, PhD, Michiaki Unno, MD, PhD. Tohoku University Graduate School of Medicine, Department of Surgery

Background and Aim: Bariatric surgery has done widely in the world and the dramatic effect is reported. However, the number is still less in our country. In our institute, bariatric surgery was introduced in October, 2010, and twenty-four cases have undergone the surgery. The procedures were laparoscopic sleeve gastrctomy (LSG) and laparoscopic sleeve gastrectomy with duodenal-jejunal bypasss (LSG/DJB). We investigated outcomes of bariatric surgery in our institution retrospectively.

Patients and Method: Twenty-four patients who undergo bariatric surgery in our hospital from 2010 to 2014 are included in this study. We measured and investigated the patients’ body weight, body mass index (BMI), percent of excess body weight loss (ExBWL%), status of metabolic diseases, operation time, blood loss, post operative length of stay and postoperative complications. The data was shown as LSG : LSG/DJB below. All data was examined by using median value.

Result: Twenty-four patients (M:F = 11:13) underwent bariatric surgery. Eighteen patients underwent LSG, and six patients underwent LSG/DJB. The median age was 38.5 (23-62) : 38 (30-58). Pre-operative body weight was 112.9kg (94.2-161.9) : 108.7kg (92-170), and BMI was 42.1 (32.6-57.5) : 36.4 (35.0-54.3) respectively. The number of patients with diabetes was 11 cases : 6 cases, and the median HbA1C level was 6.1% (4.9-11.1) : 6.6% (6.2-11.8). The operation time was 139.5min (99-224) : 271.5min (257-296), and blood loss was 10g (2-30) : 45g (10-150). Post operative length of stay was 9 days (5-15) : 10 days (8-17). ExBWL% was 53.3% (-2.5-82.2) : 53.8% (28.5-67.2) one year after surgery, and 34.8% (-10.7-89.8) : 56.1% (38.1-73.1) two years after surgery. HbA1C level was 5.6% (4.7-6.4) : 5.9% (5.0-9.0) one year after surgery, and 5.7% (4.8-7.1) : 5.5% (4.9-8.7) two years after surgery. In fourteen cases (82%), diabetes went into remission. Especially, the remission occurred in five cases of LSG/DJB (82%). Post operative complications occurred only in two cases, and both of them were grade2 (fever and intraluminal bleeding) according to Clavien-Dindo classification.

Conclusion: Bariatric surgery in our institution was effective and performed safely. In particular, the effect of improving diabetes was higher in procedure of LSG/DJB. 

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