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Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients.
Obes Surg. 2006 Sep; 16(9):1138-44.OS

Abstract

BACKGROUND

We evaluated laparoscopic sleeve gastrectomy (LSG) on major co-morbidities (hypertension, type 2 diabetes / impaired glucose tolerance, obstructive sleep apnea syndrome (OSAS) and on American Society of Anesthesiologists (ASA) operative risk score in high-risk super-obese patients undergoing two-stage laparoscopic biliopancreatic diversion with duodenal switch (LBPD-DS).

METHODS

41 super-obese high-risk patients (mean BMI 57.3+/-6.5 kg/m(2), age 44.6+/-9.7 years) were entered into a prospective study (BMI > or = 60, or BMI > or = 50 with at least two severe co-morbidities, no Prader-Willi syndrome, no conversion, minimum follow-up 12 months). 9 patients had BMI > or = 60. 17 patients (41.4%) had OSAS on C-PAP therapy. In 10 patients, at least one intragastric balloon had been positioned and 4 had undergone laparoscopic adjustable gastric banding, all with unsatisfactory results. At surgery, 41.5% were classified ASA 4 and 58.5% as ASA 3 (mean ASA score 3.4+/-0.5). Patients underwent evaluation every 3 months postoperatively and were restaged at 12 months and/or before the second step.

RESULTS

60% of major co-morbidities were cured and 24% improved. Average BMI after 6 and 12 months was 44.5+/-8.1 and 40.8+/-8.5 respectively (mean follow-up 22.2+/-7.1 months). After 12 months, 57.8% of the patients were co-morbidity-free and 31.5% had only one major co-morbid condition. At restaging, 20% of patients were still classified as ASA score 4 (OSAS on C-PAP therapy). 3 patients showed BMI <30 and were co-morbidity-free 12 months after LSG.

CONCLUSIONS

LSG represents a safe and effective procedure to achieve marked weight loss as well as significant reduction of major obesity-related co-morbidities. The procedure reduced the operative risk (ASA score) in super-obese patients undergoing two-stage LBPD-DS.

Authors+Show Affiliations

Department of Surgery P. Stefanini, University La Sapienza of Rome, Rome, Italy. gianfranco.silecchia@uniroma1.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16989696

Citation

Silecchia, Gianfranco, et al. "Effectiveness of Laparoscopic Sleeve Gastrectomy (first Stage of Biliopancreatic Diversion With Duodenal Switch) On Co-morbidities in Super-obese High-risk Patients." Obesity Surgery, vol. 16, no. 9, 2006, pp. 1138-44.
Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16(9):1138-44.
Silecchia, G., Boru, C., Pecchia, A., Rizzello, M., Casella, G., Leonetti, F., & Basso, N. (2006). Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obesity Surgery, 16(9), 1138-44.
Silecchia G, et al. Effectiveness of Laparoscopic Sleeve Gastrectomy (first Stage of Biliopancreatic Diversion With Duodenal Switch) On Co-morbidities in Super-obese High-risk Patients. Obes Surg. 2006;16(9):1138-44. PubMed PMID: 16989696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. AU - Silecchia,Gianfranco, AU - Boru,Cristian, AU - Pecchia,Alessandro, AU - Rizzello,Mario, AU - Casella,Giovanni, AU - Leonetti,Frida, AU - Basso,Nicola, PY - 2006/9/23/pubmed PY - 2007/4/4/medline PY - 2006/9/23/entrez SP - 1138 EP - 44 JF - Obesity surgery JO - Obes Surg VL - 16 IS - 9 N2 - BACKGROUND: We evaluated laparoscopic sleeve gastrectomy (LSG) on major co-morbidities (hypertension, type 2 diabetes / impaired glucose tolerance, obstructive sleep apnea syndrome (OSAS) and on American Society of Anesthesiologists (ASA) operative risk score in high-risk super-obese patients undergoing two-stage laparoscopic biliopancreatic diversion with duodenal switch (LBPD-DS). METHODS: 41 super-obese high-risk patients (mean BMI 57.3+/-6.5 kg/m(2), age 44.6+/-9.7 years) were entered into a prospective study (BMI > or = 60, or BMI > or = 50 with at least two severe co-morbidities, no Prader-Willi syndrome, no conversion, minimum follow-up 12 months). 9 patients had BMI > or = 60. 17 patients (41.4%) had OSAS on C-PAP therapy. In 10 patients, at least one intragastric balloon had been positioned and 4 had undergone laparoscopic adjustable gastric banding, all with unsatisfactory results. At surgery, 41.5% were classified ASA 4 and 58.5% as ASA 3 (mean ASA score 3.4+/-0.5). Patients underwent evaluation every 3 months postoperatively and were restaged at 12 months and/or before the second step. RESULTS: 60% of major co-morbidities were cured and 24% improved. Average BMI after 6 and 12 months was 44.5+/-8.1 and 40.8+/-8.5 respectively (mean follow-up 22.2+/-7.1 months). After 12 months, 57.8% of the patients were co-morbidity-free and 31.5% had only one major co-morbid condition. At restaging, 20% of patients were still classified as ASA score 4 (OSAS on C-PAP therapy). 3 patients showed BMI <30 and were co-morbidity-free 12 months after LSG. CONCLUSIONS: LSG represents a safe and effective procedure to achieve marked weight loss as well as significant reduction of major obesity-related co-morbidities. The procedure reduced the operative risk (ASA score) in super-obese patients undergoing two-stage LBPD-DS. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/16989696/Effectiveness_of_laparoscopic_sleeve_gastrectomy__first_stage_of_biliopancreatic_diversion_with_duodenal_switch__on_co_morbidities_in_super_obese_high_risk_patients_ L2 - https://dx.doi.org/10.1381/096089206778392275 DB - PRIME DP - Unbound Medicine ER -