Skip to main content
SpringerLink
Log in

Analysis of Morbidity Data of 308 Cases of Laparoscopic Sleeve Gastrectomy—the Soroka Experience

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) became a prevalent bariatric procedure in Israel, while laparoscopic adjustable gastric banding (LAGB) was losing ground, due to high failure rates (40 % at 10 years). Many patients after LAGB failure choose LSG as a further bariatric surgery (secondary LSG). However, LAGB often impairs upper stomach anatomy and physiology, which may contribute to complications increased risk after secondary LSG, in comparison to surgery-naive obese patients choosing LSG (primary LSG).

Methods

A retrospective cohort study was conducted on a prospective database, looking at morbidly obese patients for LSG surgery. All procedures were done by a single surgeon at the Soroka Medical Center between January 2008 and March 2013. Data were collected from hospitalization charts on demographics, biometric and bariatric status, medical and bariatric surgical history, post-LSG morbidity, and mortality.

Results

Three hundred eight patients underwent LSG during the study period, 181 (58.8 %) had a primary LSG while 127 (41.2 %) had a secondary LSG. No mortality occurred in both groups. Odds ratio for major complication (leak, stenosis) was 3.12 [CI 0.90–10.75] among the secondary LSG group, compared to the primary LSG (p = 0.071). The risk for major complication was doubled (OR = 2, 95 % CI [1.36–3.06]) for each one of previous bariatric procedure underwent (p = 0.001). Significant differences were found between the two groups regarding number and length of readmissions and number of imaging tests (p value = 0.027, 0.022, and 0.049, respectively).

Conclusions

Primary LSG is a safe and efficient bariatric procedure. After failed LAGB, secondary LSG should be carefully considered, because of a potentially higher risk of complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. CDC. CDC report of US Health in 2012. Available in: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063.

  2. [Israel] Comparison to OECD—additional details [on obesity]. Available in: http://www.health.gov.il/PublicationsFiles/HealthataGlance2013.pdf.

  3. NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Obesity in Adults (US). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. The Evidence Report: Bethesda (MD): National Heart, Lung, and Blood Institute; Report No.: 98-4083. 1998 Sept.Available in: NOEIE Panel - 1998 - ncbi.nlm.nih.gov.

  4. Batchelder AJ, Williams R, Sutton C. The evolution of minimally invasive bariatric surgery. J Surg Res. 2013;183(2):559–66.

    Article  PubMed  Google Scholar 

  5. Chapman WH, Cunningham E, Pories WJ. Bariatric surgery and diabetes: access denied. Diabetes Technol Ther. 2013;15 Suppl 1:S83–7.

    PubMed  Google Scholar 

  6. Cavarretta E, Casella G, Calì B, Dammaro C, Biondi-Zoccai G, Iossa A, et al. Cardiac remodeling in obese patients after laparoscopic sleeve gastrectomy. World J Surg. 2013;37(3):565–72.

    Article  PubMed  Google Scholar 

  7. Victorzon M, Tolonen P. Mean fourteen-year, 100 % follow-up of laparoscopic adjustable gastric banding for morbid obesity. Surg Obes Relat Dis. 2013;9(5):753–7.

    Article  PubMed  Google Scholar 

  8. Lazzati A, Guy-Lachuer R, Delaunay V, Szwarcensztein K, Azoulay D. Bariatric surgery trends in France: 2005-2011. Surg Obes Relat Dis. 2013 Aug 26. pii:S1550-7289(13)00253-0.

  9. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  10. Sabbagh C, Verhaeghe P, Dhahri A, Brehant O, Fuks D, Badaoui R, et al. Two-year results on morbidity, weight loss and quality of life of sleeve gastrectomy as first procedure, sleeve gastrectomy after failure of gastric banding and gastric banding. Obes Surg. 2010;20(6):679–84.

    Article  PubMed  Google Scholar 

  11. Bernante P, Foletto M, Busetto L, Pomerri F, Pesenti FF, Pelizzo MR, et al. Feasibility of laparoscopic sleeve gastrectomy as a revision procedure for prior laparoscopic gastric banding. Obes Surg. 2006;16(10):1327–30.

    Article  PubMed  Google Scholar 

  12. Nocca D, Krawczykowsky D, Bomans B, Noël P, Picot MC, Blanc PM, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18(5):560–5.

    Article  CAS  PubMed  Google Scholar 

  13. Anderson B, Switzer NJ, Almamar A, Shi X, Birch DW, Karmali S. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg. 2013;23(9):1476–80.

    Article  PubMed  Google Scholar 

  14. Foletto M, Prevedello L, Bernante P, Luca B, Vettor R, Francini-Pesenti F, et al. Sleeve gastrectomy as revisional procedure for failed gastric banding or gastroplasty. Surg Obes Relat Dis. 2010;6(2):146–51.

    Article  PubMed  Google Scholar 

  15. Uglioni B, Wölnerhanssen B, Peters T, Christoffel-Courtin C, Kern B, Peterli R. Midterm results of primary vs. secondary laparoscopic sleeve gastrectomy (LSG) as an isolated operation. Obes Surg. 2009;19(4):401–6.

    Article  PubMed  Google Scholar 

  16. Dapri G, Cadière GB, Himpens J. Feasibility and technique of laparoscopic conversion of adjustable gastric banding to sleeve gastrectomy. Surg Obes Relat Dis. 2009;5(1):72–6.

    Article  PubMed  Google Scholar 

  17. Frezza EE, la Jaramillo-deTorre EJ, Calleja Enriquez C, Gee L, Wachtel MS, Lopez Corvala JA. Laparoscopic sleeve gastrectomy after gastric banding removal: a feasibility study. Surg Innov. 2009;16(1):68–72.

    Article  PubMed  Google Scholar 

  18. Alqahtani AR, Elahmedi M, Alamri H, Mohammed R, Darwish F, Ahmed AM. Laparoscopic removal of poor outcome gastric banding with concomitant sleeve gastrectomy. Obes Surg. 2013;23(6):782–7.

    Article  PubMed  Google Scholar 

  19. Stroh C, Benedix D, Weiner R, Benedix F, Wolff S, Knoll C, et al. Obesity Surgery Working Group, Competence Network Obesity. Is a one-step sleeve gastrectomy indicated as a revision procedure after gastric banding? Data analysis from a quality assurance study of the surgical treatment of obesity in Germany. Obes Surg. 2014;24(1):9–14.

    Article  PubMed  Google Scholar 

  20. Iannelli A, Schneck AS, Ragot E, Liagre A, Anduze Y, Msika S, et al. Laparoscopic sleeve gastrectomy as revisional procedure for failed gastric banding and vertical banded gastroplasty. Obes Surg. 2009;19(9):1216–20.

    Article  PubMed  Google Scholar 

  21. Acholonu E, McBean E, Court I, Bellorin O, Szomstein S, Rosenthal RJ. Safety and short-term outcomes of laparoscopic sleeve gastrectomy as a revisional approach for failed laparoscopic adjustable gastric banding in the treatment of morbid obesity. Obes Surg. 2009;19(12):1612–6.

    Article  PubMed  Google Scholar 

  22. Jacobs M, Gomez E, Romero R, Jorge I, Fogel R, Celaya C. Failed restrictive surgery: is sleeve gastrectomy a good revisional procedure? Obes Surg. 2011;21(2):157–60.

    Article  PubMed  Google Scholar 

  23. Liu KH, Diana M, Vix M, Mutter D, Wu HS, Marescaux J. Revisional surgery after failed adjustable gastric banding: institutional experience with 90 consecutive cases. Surg Endosc. 2013;27(11):4044–8.

    Article  PubMed  Google Scholar 

  24. Utech M, Shaheen H, Halter J, Riege R, Knapp A, Wolf E, et al. Article in German]. [Sleeve gastrectomy as a revision procedure for failed gastric banding. Zentralbl Chir. 2014;139(1):79–82.

    CAS  PubMed  Google Scholar 

  25. Goitein D, Feigin A, Segal-Lieberman G, Goitein O, Papa MZ, Zippel D. Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surg Endosc. 2011;25(8):2626–30.

    Article  PubMed  Google Scholar 

  26. Berende CA, de Zoete JP, Smulders JF, Nienhuijs SW. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Yazbek T, Safa N, Denis R, Atlas H, Garneau PY. Laparoscopic sleeve gastrectomy (LSG)—a good bariatric option for failed laparoscopic adjustable gastric banding (LAGB): a review of 90 patients. Obes Surg. 2013;23(3):300–5.

    Article  PubMed  Google Scholar 

  28. Gagnière J, Slim K, Launay-Savary MV, Raspado O, Flamein R, Chipponi J. Previous gastric banding increases morbidity and gastric leaks after laparoscopic sleeve gastrectomy for obesity. J Visc Surg. 2011;148(3):e205–9.

    Article  PubMed  Google Scholar 

  29. Germanova D, Loi P, van Vyve E, Johanet H, Landenne J, Closset J, et al. Previous bariatric surgery increases postoperative morbidity after sleeve gastrectomy for morbid obesity. ActaChir Belg. 2013;113(4):254–7.

    CAS  Google Scholar 

  30. Israel A, Sebbag G, Frazer D, Levy I. Nutritional behavior as a predictor of early success after gastroplasty. Obes Surg. 2005;15(1):88–94.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

This work was not supported by any grant, and all the authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Surgery Department B, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 151, Beer Sheva, 84101, Israel

    Ohad Guetta, Amnon Ovnat, Gad Shaked, David Czeiger & Gilbert Sebbag

Authors
  1. Ohad Guetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amnon Ovnat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gad Shaked
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David Czeiger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gilbert Sebbag
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gilbert Sebbag.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guetta, O., Ovnat, A., Shaked, G. et al. Analysis of Morbidity Data of 308 Cases of Laparoscopic Sleeve Gastrectomy—the Soroka Experience. OBES SURG 25, 2100–2105 (2015). https://doi.org/10.1007/s11695-015-1665-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-015-1665-z

Keywords

Search

Navigation