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OBES SURG (2008) 18:566568 DOI 10.1007/s11695-007-9302-0
RESEARCH ARTICLE
Laparoscopic Sleeve Gastrectomy as an Alternative to Gastric Bypass in Patients with Multiple Intraabdominal Adhesions
Bernab Matas Quesada & Hernn Eduardo Roff &
Gustavo Kohan & Alejandro Salvador Ora &
Luis Toms Chiappetta Porras
Received: 11 June 2007 /Accepted: 21 September 2007 / Published online: 15 March 2008 # Springer Science + Business Media B.V. 2007
AbstractBackground Laparoscopic sleeve gastrectomy and its indications are currently being evaluated. The objective of this study was to show the preliminary results obtained with this technique indicated as an alternative to gastric bypass in patients with multiple intraabdominal adhesions, therefore preserving the benefits of the laparoscopic approach. Methods An analysis of all patients who underwent a laparoscopic sleeve gastrectomy for the above indication was done. Data included demographics, number of previous surgeries, operative time, morbidity, mortality, and %EWL at 3 and 6 months.
Results Fifteen patients underwent laparoscopic sleeve gastrectomy as an alternative to gastric bypass because of multiple intraabdominal adhesions. No patient required conversion to an open procedure; morbidity was 6% with no mortality. %EWL at 3 months was 41% and at 6 months was 44%. Mean follow-up was 6 months.
Conclusion In our initial experience, laparoscopic sleeve gastrectomy proved to be a safe and effective alternative to gastric bypass for patients with multiple intraabdominal adhesions.
Keywords Laparoscopy. Sleeve gastrectomy. Gastric bypass
Introduction
Sleeve gastrectomy has been initially proposed as the first stage procedure of the duodenal switch operation for patients with body mass index (BMI) >60, with the objective of keeping a low morbidity and mortality rate in that high-risk population [14]. Its current role in bariatric surgery and indications are still under evaluation. A number of these have been described and include patients with low BMI needing a restrictive operation [5], patients with failed gastric banding requiring band removal [6], patients needing long-term anticoagulation [7], patients with severe medical illnesses such as cirrhosis, Crohns disease [3], patients requiring endoscopic surveillance for chronic gastric diseases, among many others.
The objective of this study was to present our preliminary results with laparoscopic sleeve gastrectomy indicated as an alternative to gastric bypass in patients with multiple intraabdominal adhesions who were originally scheduled for laparoscopic gastric bypass.
Material and Methods
Indications...