Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity?

Obes Surg. 2006 Feb;16(2):166-71. doi: 10.1381/096089206775565276.

Abstract

Background: Sleeve gastrectomy as the sole bariatric operation has been reported for high-risk super-obese patients or as first-step followed by Roux-en-Y gastric bypass (RYGBP) or duodenal switch (DS) in super-super obese patients. The efficacy of laparoscopic sleeve gastrectomy (LSG) for morbidly obese patients with a BMI of <50 kg/m2 and the incidence of gastric dilatation following LSG have not yet been investigated.

Methods: 23 patients (15 morbidly obese, 8 super-obese) were studied prospectively for weight loss following LSG. The incidence of sleeve dilatation was assessed by upper GI contrast studies in patients with a follow-up of >12 months.

Results: Patients who underwent LSG achieved a mean excess weight loss (EWL) at 6 and 12 months postoperatively of 46% and 56%, respectively. No significant differences were observed in %EWL comparing obese and super-obese patients. At a mean follow-up of 20 months, dilatation of the gastric sleeve was found in 1 patient and weight regain after initial successful weight loss in 3 of the 23 patients.

Conclusion: LSG has been highly effective for weight reduction for morbid obesity even as the sole bariatric operation. Gastric dilatation was found in only 1 patient in this short-term follow-up. Weight regain following LSG may require conversion to RYGBP or DS. Follow-up will be necessary to evaluate long-term results.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Gastric Dilatation / epidemiology
  • Gastric Dilatation / etiology*
  • Humans
  • Incidence
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / surgery*
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Statistics, Nonparametric
  • Treatment Outcome