Complications after laparoscopic sleeve gastrectomy.
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG) has recently become a feasible option in the management of morbid obesity. The objective of this study was to examine the morbidity and mortality arising from LSG as a primary procedure for weight loss.


METHODS
We retrospectively reviewed the data of 164 patients who underwent LSG from 2004 to 2007. Patients underwent LSG as a primary procedure or as revisional bariatric surgery. The short-term morbidity and mortality were examined.


RESULTS
One-stage LSG was performed in 148 patients. The major complication rate was 2.9% (4 of 149), including 1 leak (0.7%) and 1 case of hemorrhage (0.7%)-each requiring reoperation-1 case of postoperative abscess (0.7%), and 1 case of sleeve stricture that required endoscopic dilation (0.7%). One late complication of choledocholithiasis and bile duct stricture required a Whipple procedure. LSG was used as revisional surgery in 16 patients (9%); of these, 13 underwent LSG after complications related to laparoscopic adjustable gastric banding, 1 underwent LSG after aborted laparoscopic Roux-en-Y gastric bypass, and 2 underwent LSG after failed jejunoileal bypass. One of these patients developed a leak and an abscess (7.1%) requiring reoperation. One case was aborted, and 2 cases were converted to an open procedure secondary to dense adhesions. No patient died in either group. All but 3 cases were completed laparoscopically (98%).


CONCLUSIONS
LSG is a relatively safe surgical option for weight loss as a primary procedure and as a primary step before a secondary nonbariatric procedure in high-risk patients.
Lalor
Peter F
PF
Bariatric Institute and Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida, USA.
Tucker
Olga N
ON
Szomstein
Samuel
S
Rosenthal
Raul J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss