Laparoscopic Sleeve Gastrectomy: Review of 536 Cases and 2 Year Follow Up

INTRODUCTION: LSG is increasingly performed among surgeons as a sole bariatric procedure. The aim of this study was to describe the results of Laparoscopic Sleeve Gastrectomy (LSG) on the first 536 patients performed in our institution as a definitive procedure
METHODS AND PATIENTS: We conducted a review of our prospective electronic database for patients who underwent LSG as a sole bariatric procedure from August 2005 to September 2008. We assessed surgical results, complications, weight progression and resolution of co-morbid conditions.
RESULTS: In this period, 536 patients underwent LSG (77.8% females). Mean age was 36.7±11.6 years. Mean preoperative BMI was 36.1±5.8 kg/m2 (28.7– 60.5). Mean operatory time was 76.8±28.3 minutes. There were no conversions to open surgery. Mean hospital stay was 2.8±0.8 days. Thirteen patients (2.4%) had early complications: 4 portal vein thrombosis (0.7%), 3 wound infections (0.6%), 2 leaks (0.3%), 2 hemoperitoneum (0.3%), 1 antral stenosis and 1 acute pancreatitis. No mortality was observed. Three patients required reoperation (2 leaks and antral stenosis). Seventeen patients (3.2%) developed late complications mainly due to cholelitiasis (6) and gastroesophageal reflux (3). Median follow up time was 12 months (1–36). Percent excess weight loss at 6, 12 and 24 months was 80.1±24.9%, 88.3±29.2% and 88.5±33%.
Preoperative comorbidities were dyslipidemia (DLP) 66%, type 2 diabetes (T2D) 6%, insuline resistance (IR) 54% and arterial hypertension (HTN )20%. Resolution or improvement of comorbidities at follow-up was 64% for DLP, 88% for T2D, 94% for IR and 73% for HTN.
CONCLUSIONS: LSG proved to be effective and safe. Complication rate is low, however a high incidence of portal vein thrombosis needs to be carefully studied.

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Program Number: P073

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