Laparoscopic sleeve gastrectomy: perioperative outcomes,weight loss and impact on type 2 diabetes mellitus over 2 years

Background

Laparoscopic sleeve gastrectomy (LSG) is an increasingly performed operation for morbid obesity worldwide. To date there has been limited experience in Canada. We report our intermediate results, assessing whether LSG can be safely performed at a Canadian academic teaching hospital and whether it is effective as a bariatric procedure and as metabolic therapy for type 2 diabetes mellitus.

Methods

We performed a retrospective review of all patients who underwent LSG at our institution from Sept. 1, 2007, to June 30, 2011.

Results

We included 166 patients (mean age 44 yr, 82% female) in our study. The mean preoperative body mass index was 49.61. At baseline, 87 (52%) patients had type 2 diabetes. For this subgroup, mean preoperative HbA1c and AC glucose were 7.6% and 8.3 mmol/L, respectively. The mean duration of surgery was 93 minutes. Major complications included 1 staple line leak (0.6%), and 2 patients required reintervention for bleeding (1.2%). The mean hospital stay was 2.6 days. Two patients required readmission (1.2%). Seven minor complications occurred (4%). Postoperative excess weight loss was 49.3% at 6 months, 54.2% at 12 months and 64.4% at 24 months. In the type 2 diabetes subgroup, resolution occurred in 78% and improvement in 7% of patients at 12 months.

Conclusion

Laparoscopic sleeve gastrectomy can be safely performed at Canadian teaching hospitals. It is effective both as a bariatric procedure and as a therapeutic intervention for type 2 diabetes mellitus.