Gastric Banding Research Today is a free monthly online journal that collates and summarizes the latest research about Gastric Banding, including details on laparoscopic gastric banding, stomach stapling, gastric bypass, risks, diet.

Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients.

Silecchia G, Boru C, Pecchia A, Rizzello M, Casella G, Leonetti F, Basso N

Department of Surgery "P. Stefanini", University "La Sapienza" of Rome, Italy.

BACKGROUND: We evaluated laparoscopic sleeve gastrectomy (LSG) on major co-morbidities (hypertension, type 2 diabetes / impaired glucose tolerance, obstructive sleep apnea syndrome (OSAS) and on American Society of Anesthesiologists (ASA) operative risk score in high-risk super-obese patients undergoing two-stage laparoscopic biliopancreatic diversion with duodenal switch (LBPD-DS).METHODS: 41 super-obese high-risk patients (mean BMI 57.3+/-6.5 kg/m(2), age 44.6+/-9.7 years) were entered into a prospective study (BMI >/=60, or BMI >/=50 with at least two severe co-morbidities, no Prader-Willi syndrome, no conversion, minimum follow-up 12 months). 9 patients had BMI >/=60. 17 patients (41.4%) had OSAS on C-PAP therapy. In 10 patients, at least one intragastric balloon had been positioned and 4 had undergone laparoscopic adjustable gastric banding, all with unsatisfactory results. At surgery, 41.5% were classified ASA 4 and 58.5% as ASA 3 (mean ASA score 3.4+/-0.5). Patients underwent evaluation every 3 months postoperatively and were restaged at 12 months and/or before the second step.RESULTS: 60% of major co-morbidities were cured and 24% improved. Average BMI after 6 and 12 months was 44.5+/-8.1 and 40.8+/-8.5 respectively (mean follow-up 22.2+/-7.1 months). After 12 months, 57.8% of the patients were co-morbidity-free and 31.5% had only one major co-morbid condition. At restaging, 20% of patients were still classified as ASA score 4 (OSAS on C-PAP therapy). 3 patients showed BMI <30 and were co-morbidity-free 12 months after LSG.CONCLUSIONS: LSG represents a safe and effective procedure to achieve marked weight loss as well as significant reduction of major obesity-related co-morbidities. The procedure reduced the operative risk (ASA score) in super-obese patients undergoing two-stage LBPD-DS.

Published 22 September 2006 in Obes Surg, 16(9): 1138-44.
Full-text of this article is available online (may require subscription).

© 2004-2008 Gastric Banding Research Today. All Rights Reserved.