title: Laparoscopic greater curvature plication: surgical techniques and early outcomes of a Chinese experience.
abstract: BACKGROUND
  Laparoscopic greater curvature plication (LGCP) is a novel restrictive bariatric procedure that can reduce the gastric volume by infolding the gastric greater curvature without gastrectomy. The objective of this study was to describe the surgical technique of LGCP and validate the efficacy and safety of LGCP for the treatment of obesity in obese Chinese patients with a relatively low body mass index (BMI).
  
  
  METHODS
  Twenty-two obese patients (mean age 33.8±6.0 years; mean BMI 37.0±7.0 kg/m(2)) underwent LGCP between September 2011 and September 2012. After dissecting the greater omentum and short gastric vessels, the gastric greater curvature plication with 2 rows of nonabsorbable suture was performed under the guidance of a 32-F bougie. The data were collected during follow-up examinations performed at 1, 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  All procedures were performed laparoscopically. The mean operative time was 84.1 minutes (50-120 min), and the mean length of hospital stay was 3.8 days (2-10 d). There were no deaths or postoperative major complications that needed reoperation. The mean percentage of excess weight loss (%EWL) was 22.9%±6.9%, 38.6%±9.8%, 51.5%±13.5%, and 61.1%±15.9% at 1, 3, 6, and 12 months postoperatively. At 6 months, type 2 diabetes was in remission in 2 (50%) patients, hypertension in 1 (33.3%) patient, and dyslipidemia in 11 (78.6%) patients. Decreases in the index for homeostasis model assessment of insulin resistance (HOMA-IR) and in insulin and glucose concentrations were observed.
  
  
  CONCLUSIONS
  The early outcomes of LGCP as a novel treatment for obese Chinese with a relatively low BMI are satisfactory with respect to the effectiveness and low incidence of major complications. Additional long-term follow-up and prospective, comparative trials are still needed.
authors.affiliation: Department of General Surgery and Laparoscopic Center, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, People's Republic of China; Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou People's Republic of China.
authors.forename: Dijian
authors.initials: D
authors.lastname: Shen
authors.affiliation: Clinical Medical School, Hangzhou Normal University, Hangzhou, People's Republic of China.
authors.forename: Huan
authors.initials: H
authors.lastname: Ye
authors.affiliation: Department of General Surgery and Laparoscopic Center, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, People's Republic of China. Electronic address: wydong2003@hotmail.com.
authors.forename: Yuedong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of General Surgery and Laparoscopic Center, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, People's Republic of China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of General Surgery and Laparoscopic Center, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, People's Republic of China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhan
authors.affiliation: Department of General Surgery and Laparoscopic Center, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, People's Republic of China.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Greater curvature plication; Laparoscopic bariatric surgery; Morbid obesity; Restrictive procedure