Efficacy of laparoscopic greater curvature plication for weight loss and type 2 diabetes: 1-year follow-up.
BACKGROUND
Laparoscopic greater curvature plication (LGCP) has gained popularity within the last 2 years because it is a restrictive procedure that reduces gastric volume without the need for stomach resection.


METHODS
A prospective study was performed in which 55 morbidly obese patients with type 2 diabetes (44 female, 11 male) underwent LGCP. The patients had a mean age of 38.5 years (22-55 years), mean BMI of 43.5 kg/m(2) (35-52 kg/m(2)), and mean glycosylated hemoglobin (HbA1c) of 7.9 % (6-10 %).


RESULTS
All procedures were completed laparoscopically. The mean operative time was 55 min (40-80 min), and the mean hospital stay was 1.8 days (1.5-5 days). No intraoperative or postoperative complications were reported apart from three cases of resistant nausea and vomiting and one case of intraluminal bleeding. The mean excess weight loss (EWL%) was 35 % (30-65 %) after 12 months with a mean BMI of 38 kg/m(2) after 12 months. A total of 23 % of patients stopped losing weight 6 months after the procedure, and 11 % began regaining about 14 % (12-20 %) of their EWL 9 months after the procedure. The mean HbA1c was 7.5 % (5.5-8 %) after 12 months.


CONCLUSIONS
LGCP is feasible and safe in the short term when applied to morbidly obese patients, but may be unsustainable. It is inferior as a restrictive procedure for resolution of type 2 diabetes. Longer follow-up and prospective comparative trials are needed to clarify whether it can be considered an effective single-stage procedure for treating morbidly obese diabetic patients and their comorbidities.
Assiut University, Assiut, Egypt. osama.taha@bariatriccenter-eg.com
Osama
O
Taha
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D061646:Operative Time; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human