Ann Surg Treat Res.  2019 May;96(5):259-265. 10.4174/astr.2019.96.5.259.

Outcomes of primary sleeve gastrectomy versus conversion sleeve gastrectomy in morbidly obese patients

• Park JS
• Han SM

• KMID: 2443589
• DOI: http://doi.org/10.4174/astr.2019.96.5.259

Abstract

PURPOSE
Our aim for this study was to evaluate early and late complications and outcomes of primary sleeve gastrectomy (PSG) versus conversion sleeve gastrectomy (CSG).
METHODS
From February 2013 to December 2016, a total of 180 patients underwent sleeve gastrectomy (150 PSG and 30 CSG). All patients received a metal clipping at the end of the stapling line and a continuous seromuscular suture at the resection margin, for reinforcement.
RESULTS
There were no differences in the percentages among males and females or age between the 2 groups, but the body mass index (BMI) of the PSG group was higher at 36.8 ± 4.7 than that of the CSG group (32.4 ± 5.7, P < 0.001). Three early postoperative complications were noted in the PSG group; 1 patient underwent repeat laparoscopic exploration due to pancreatic injury, and 2 other patients developed pulmonary atelectasis. On the contrary, 2 early minor complications were noted in the CSG group. Thirty-eight patients (25.3%) in the PSG group developed 43 late, minor complications, while 9 patients (30.0%) developed 11 late minor and 1 major complication in the CSG group. However, there was no difference in complication rate between PSG and CSG. Percentage excess BMI loss at 3, 6, and 12 months after surgery was comparable between the groups.
CONCLUSION
PSG and CSG were comparable in terms of postoperative complications and loss of weight. Therefore, CSG could be used for failed primary restrictive bariatric surgery. However, the durability of these outcomes remains unknown.

Keyword

Bariatric surgery; Reoperation

MeSH Terms

Bariatric Surgery
Body Mass Index
Female
Gastrectomy*
Humans
Male
Postoperative Complications
Pulmonary Atelectasis
Reoperation
Sutures

Figure

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  Fig. 1 Metal clipping at each end of stapling line.

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  Fig. 2 Continuous seromuscular reinforcement suture at resection margin.

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