Sleeve Gastrectomy, The Most Feasible Surgical Weight Loss Procedure For Morbidly Obese Patients In Pakistan: Early Results

Abstract

Background: The laparoscopic sleeve gastrectomy is a new tool in the surgical treatment of the
morbidly obese patients which is now increasingly used as a primary surgical procedure for the
morbid obesity as it has comparable weight loss to laparoscopic adjustable gastric banding and
better safety profile than the Gastric Bypass with no malabsorption.
We describe initial results of laparoscopic sleeve gastrectomy for morbid obesity in two academic
centers of Pakistan.
Materials and Method: Prospective data was collected on consecutive morbidly obese
patients undergoing laparoscopic sleeve gastrectomy, and evaluated retrospectively.
Results: Twenty one consecutive patients underwent laparoscopic sleeve gastrectomy from
October 2008 to August 2010 with follow up ranging from 2 to 15 months. The 8 men and 13
women had an average age of 42.1 years (range 2152 years) and an average body mass index
(BMI) of 49.6 kg/m2 (range 35.272.2 kg/m2). No operation required conversion to laparotomy.
Mean length of stay was 2.1 days (range 110 days). There was no death in the 30 days
postoperatively. One patient was admitted with pain abdomen after 10 days of operation with
portal pyemia but settled conservatively. Other complications included one suspected clinical
leak but no radiological leak. Patient got settled with conservative management in one week. Two
patients had repeated vomiting off and on for one month and inability to take water which resolved
spontaneously. At 1-year follow-up all patients had lost an average of 52.0% excess body weight.
Conclusion: Laparoscopic sleeve gastrectomy has much to offer for the morbidly obese. We
present data showing weight loss rivaling gastric banding and bypass and acceptably low
complications.