Comparison of short-term outcomes between laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy

Shen, Deyan; Ye, Huan; Wang, Yuedong; Ji, Yun; Zhan, Xiaoli; Zhu, Jinhui; Li, Wei

doi:10.1007/s00464-013-2805-y

Cited by 59 publications

(47 citation statements)

References 23 publications

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“…19 Different studies had shown marked improvement in the preoperative co-morbidities following stomach plication technique. 9,17 In the present study improvement in co-morbidities was evident in 7 patients of 13 patients (53.8%). The improvement was more in those complaining of hypertension (3/4) and those who have joint pains (3/6) and lastly those having type II diabetes (1/3).…”

Section: Discussionsupporting

confidence: 58%

See 1 more Smart Citation

Laparoscopic greater curvature plication as a stomach sparing gastric sleeve: is it a worthy weight losing procedure for morbid obesity?

Abdallah¹,

Nemr²

2018

Int Surg J

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INTRODUCTIONMorbid obesity is a rapidly growing health problem all over the world. It threatens the life of different peoples and different age groups. 1 Bariatric surgery today is considered as the most effective way of management for persistent weight loss and for relieving the associated comorbidities and to improve the quality of life. 2 However, surgeons still have debates regarding the ideal weight loss procedure. Laparoscopic sleeve gastrectomy (LSG), which is one of the most popular bariatric surgery worldwide, has 2 serious complications leakage and bleeding from staple line with variable incidence ranging from 1.2 and 3.6 % respectively and can lead to serious outcome. 3,4 In an attempt to reduce these serious complications, another gastric restrictive technique came into view, notably, gastric plication that was first used as weight reducing procedure through an open approach. 5 Talebpour and Amoli were the first to perform the procedure through laparoscopy. 6 A ABSTRACT Background: Although laparoscopic sleeve gastrectomy (SLG) considered a gold standard way of management of morbid obesity, it still has serious complications as bleeding and staple line leak. Laparoscopic greater curvature plication (LGCP) was introduced as a trial gastric restrictive procedure and recently modified and standardized to obtain a gastric sleeve without resection and hence lower complications rates with the advantage of being a reversible procedure. Methods: 28 patients suffered from morbid obesity with body mass indices less than 50 kg/m 2 filling the selection criteria of the study were prepared for Stomach Sparing Gastric Sleeve (SSGS). After devascularization of the greater curvature, double in-folding of the greater curvature using non-absorbable 2-0 sutures starting at the angle of His to 3-4 cm proximal to the pylorus, were done. Results: 28 patients with preoperative mean total body weight (TBW) of 118.7±15.5 kg and a mean BMI of 38±6.5 kg/m 2 were the target of this study. The mean operative time was 103±11 min. Early minor postoperative complications were detected in 18 patients (64%) and included nausea, vomiting and sialorrhea. Postoperative reflux esophagitis was detected in 2 patients (7%). Postoperative % EWL (excess weight loss) was 32.2% at 1 month, 48.9% at 3 months, 53.3% at 6 months, 66.7% at 12 months and 70.2% at 15 months. The improvement of the pre-existent co-morbidities occurred in 7 patients (53.8%). Conclusions: SSGS is a promising low cost restrictive bariatric operation. It is reversible and effective weight losing procedure in the short term.

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Section: Discussionsupporting

confidence: 58%

“…Another explanation of failure to lose weight sufficiently was due to insufficient lowering of Ghrelin hormone release from the gastric fundus. 17 The hospital stay in the present study was 3.3±1.6 days (3-5 days) and patients started oral feeding on 2 nd day.…”

Section: Discussionmentioning

confidence: 58%

Laparoscopic greater curvature plication as a stomach sparing gastric sleeve: is it a worthy weight losing procedure for morbid obesity?

Abdallah¹,

Nemr²

2018

Int Surg J

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“…Some authors prefer 2 rows of running sutures, some used 2 rows of interrupted sutures and others recommend a combination of running and interrupted sutures. 3,7,8,10,11,16,17,20,21 Inner layer sutures are better to be taken in an interrupted manner to adjust the plication and to avoid suture breaking of continuous layer leading to failure. The outer layer should be running stitch to avoid herniation in between.…”

Section: Resultsmentioning

confidence: 99%

“…10 Another prospective non-randomized study concluded that LGP is inferior to LSG as a restrictive procedure for weight loss, despite its significantly smaller cost at short term. 11 This lack of enthusiasm in LGP could be due to three main reasons which are:…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic gastric plication: towards standardization

2017

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Background: Laparoscopic gastric plication (LGP) is a restrictive bariatric procedure which was found to be safe, effective and economic as well. However, it hasn't a good reputation among some bariatric surgeons due to some reasons; the most important of them is lack of standardization. Objective of the present stud was to study propose a standardized technique for LGP aiming at a better outcome. Setting. Settings: University-affiliated hospital.Methods: This is a retrospective analysis of patients who underwent LGP by the proposed technique., using seromuscular bites with non-absorbable thread, adoption of the four-bite technique, and calibration using bougie.Results: Eighty-eight consecutive morbidly obese patients had been operated by the proposed standardized technique of LGP between March 2010 and September 2014. There were 19 men and 69 women, with a mean age of 30.3 years and a mean BMI of 36.7kg/m2 (range 32-51kg/m2). The most frequently reported complication was prolonged early postoperative nausea/vomiting occurred in 5 of 88 (5.7%) patients. Weight regain was reported in one patient who was treated with conversion of LGP to laparoscopic mini-gastric bypass. Hospital stay was prolonged for a mean of 6.0 (3 -10 days). Postoperative follow-up period ranged from 2 to 38 months with a mean of 15 months. Percentage of excess weight loss was 38.2%, 52.0%, and 63.1% at 3, 6, and 12 months, respectively.Conclusions: The proposed technique of LGP would help in standardization of the procedure in order to improve the outcome; however, the clinical application of this proposed standardized technique should be tested by future studies.

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“…[16] Shen et al have reported success rates lower than that of sleeve gastrectomy at the early stage. [17] El-Geider et al have published the 4-bit technique recommended by Talebpour and described a firm plication technique defining a 4-needle passage at each suture, which begins 2 cm below the His angle. [18] When compared to sleeve gastrectomy, the decrease in restrictive effect and weight re-gain are higher in the longterm.…”

Section: Discussionmentioning

confidence: 99%