Laparoscopic sleeve gastrectomy (LSG) is an essential bariatric procedure performed in obese patients, which provides significant weight loss and has a positive impact on obesity-related diseases. However, as with any surgical procedure, it carries the risk of complications. The complications that can arise in patients following LSG are divided into acute (diagnosed within 30 days after the surgery) and late. Early complications that require rapid management include haemorrhage (intraluminal or extraluminal), leak in the staple line, and abscess formation. Late complications include gastric stenosis, nutrient deficiencies, mediastinal pouch migration, and the development or exacerbation of gastroesophageal reflux diseases. In this review, we present the basic information about most common complications following LSG, and their symptoms, diagnostic tools, and management.

Background The incidence of obesity has been constantly growing and bariatric procedures are considered to be the most effective treatment solution for morbidly obese patients. The results of laparoscopic sleeve gastrectomy (LSG) may differ depending on patient’s age, gender, preoperative body mass index (BMI) and physical activity. Methods The aim of this study was to evaluate age-related differences in the outcome of LSG in terms of weight loss parameters, lipid and carbohydrate profile. The retrospective analysis of 555 patients who had undergone LSG was performed to compare the metabolic outcomes of surgery in individuals < 45 and ≥ 45 years old. Evaluation of weight loss parameters along with selected laboratory data was performed to demonstrate the results of LSG in 2 years follow-up. Results Overall, 238 males and 317 females (43%/57%) with median age of 43 years and median preoperative BMI of 46.41 (42.06–51.02) kg/m2 were analyzed. Patients in both groups presented significant weight loss at 24 months after the surgery with comparable percentage of total weight loss (40.95% in < 45 years old group and 40.44% in ≥ 45 years old group). The percentage of excess weight loss (78.52% vs. 74.53%) and percentage of excess BMI loss (91.95% vs. 88.01%) were higher in patients < 45 years old. However, the differences were not statistically significant (p = 0.662, p = 0.788 respectively). Patients under 45 years old experienced faster decrease in fasting glucose level that was observed after only 3 months (109 mg/dl to 95 mg/dl in < 45 years old group vs. 103.5 mg/dl to 99.5 mg/dl in ≥ 45 years old group, p < 0.001). Both groups presented improvement of lipid parameters during the observation. However, patients < 45 years old achieved lower values of LDL at 3 and 12 months follow-up (115 mg/dl vs. 126 mg/dl, p = 0.010; 114.8 mg/dl vs. 122 mg/dl, p = 0.002). Younger group of patients also showed superior improvement of triglycerides level. Conclusions LSG results in significant weight loss in all patients regardless age. In turn, superior and faster improvement in lipid and carbohydrate profile is achieved in patients under 45 years old.

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Background: The first case of COVID-19 (Coronavirus Disease 2019) in Poland was reported on March 4th, 2020 and resulted in cancellation of bariatric procedures during the lockdown in Poland. The lockdown caused difficult access to all means of medical care. The study was conducted show the impact of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus) pandemic on bariatric patients’ status in one of Polish regions. Methods: The survey was designed and distributed to bariatric patients. The questionnaire was divided into two parts: demographic characteristics of participants and part concerned the impact of the pandemic on bariatric patients. Results: 116 bariatric patients participated in the survey. 109 of them (94%) reported at least one accompanying disease. The mean value of the willingness to perform the bariatric procedure among women it was 8.8 (±2.2 SD) and men 8.5 (±2.3 SD). The mean value of the impact of SARS-CoV-2 pandemic on the willingness to perform the bariatric in the group of women was 3.0 (±3.0 SD) and in the group of men - 3.2 (±3.0 SD). Statistical analysis shows that there is no statistically significant difference between those date. Conclusions: Despite the pandemic and higher risk of mortality and complications after COVID-19 infection, bariatric patients declare the high level of willingness to perform the bariatric procedure and the impact of SARS-CoV-2 pandemic does not play an important role in a process of deciding to undergo the bariatric procedure. Delay of surgery can significantly increase the disease load in these patients, so cancelling or postponing treatment is not advisable.

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