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Laparoscopic Sleeve Gastrectomy: a Retrospective Review of 1 and 2 Year Results

Introduction
Laparoscopic Gastric Bypass, Gastric Banding, and Biliopancreatic/Duodenal Switch are three proven surgical methods for treating morbid obesity. Recently, Laparoscopic Sleeve Gastrectomy (LSG) has been added as a surgical treatment for obesity. We report our one and two year results with LSG.
Methods
All procedures were performed by two surgeons experienced in bypass, banding, and LSG. All patients included in the study chose LSG over bypass or banding. From September, 2005, we have performed 247 LSGs. We retrospectively reviewed our 1 and 2 year data to assess weight loss, BMI, percentage of excess weight loss (%EWL), length of stay (LOS), complications, and resolution of diabetes. Early in our study, a 46 French Bougie and 7cm antral pouch was used. We then began to use a 40 Fr Bougie. Currently, we are using a 36 Fr Bougie and a 4cm antral pouch.
Results
A total of 41 patients were eligible for follow-up at 2 years, and 158 patients were eligible for follow-up at 1 year. Data was available on 34/41 pts for 2 years and 132/158 pts for 1 year. Initial mean age (years), mean weight (lbs), and mean BMI for 1 year data was 43.2, 270.8, and 44.3, respectively. Initial mean age (years), mean weight (lbs), and mean BMI for 2 year data was 41.4, 273.3, and 45.1, respectively. Mean weight loss (lbs), BMI, and %EWL, for pts at 1 year and 2 years was 89.3, 29.6, 78% and 87.5, 30.0, and 75%, respectively. There was no significant difference in the 46 Fr, 40 Fr, or 36 Fr Bougie with respect to weight loss, BMI, or %EWL. Likewise, there was no difference seen between the 7cm vs. 4cm antral pouch. Mean LOS for both groups was 1.1 days. A total of 12 complications occurred, including 1 (0.6%) death and 2 (1.3%) leaks. A total of 39 patients were diabetic. Of these 39 pts, 32 (82%) were cured of diabetes. The remaining 7 pts had their medications decreased.
Conclusion
Our results show LSG is a safe and effective weight loss procedure with results similar to those of gastric bypass. Additional long-term studies are still needed to accurately compare Laparoscopic Sleeve Gastrectomy to Gastric Bypass and/or Gastric Banding.


Session: Podium Presentation

Program Number: S109

48

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