A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional
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4th INTERNATIONAL CONSENSUS SUMMIT FOR SLEEVE GASTRECTOMY III: Long-term Results patient underwent laparoscopic seromyotomy (Table 2). We believe that the use of a bougie size of 38 Fr and a prudent oversewing of the staple line over the bougie yield an acceptable complication rate and successful weight loss. The overall morbidity in our series is reported as 24.8 percent. The early major complication rate was 1.6 percent and late complication rate, 23.2 percent (Table 2), which is in line with the results published in the literature.7,8 As expected, the patients undergoing revisional bariatric surgery had a greater complication rate than those undergoing a primary procedure (7.1% versus 2.9%).3 TABLE 2. Early and late complications COMPLICATION % (N) EXPLANATION Leak 0.3 (2) GE junction Hemorrhage 0.3 (2) Liver Trocar site Strictures 0.9 (5) Balloon dilatation EARLY Previous eroded band. Required LRYGB Previous band. Required LRYGB CONCLUSION LSG is a safe and durable surgical procedure for morbid obesity. The weight loss seems to correlate with the bougie size, but smaller diameter can lead to increased number of complications, such as strictures, leaks, and GERD. Revisional LSG procedures result in higher, but acceptable, complication rates. Required mini-bypass (high stricture) Seromyotomy LATE TOTAL REFERENCES 1. 2. 3. 4. Marceau P, Biron S, Bourque RA, et al. Biliopancreatic diversion with a new type of gastrectomy. Obes Surg. 1993;3:29–35. Abu-Jaish W, Rosenthal RJ. Sleeve gastrectomy: a new surgical approach for morbid obesity. Exp Rev of Gastro Hep. 2010;4:101–119. Lalor PF, Tucker ON, Szomstein S, Rosenthal RJ. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;4(1):33–38. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–1029. 5. 6. 7. 8. GERD 23.2 (127) 10 (1.8%) conversion LRYGB 24.8% (136) Nakazato M, Murakami N, Date Y, et al. A role for ghrelin in the central regulation of feeding. Nature. 2001;409:194–198. Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2009;19:134. Silecchia G, Boru C, Pecchia A, et al. 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;16:1138–1144. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–864. May 2013 • Supplement A • Bariatric Times A13