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Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Greater Curvature Plication: a Long-Term Follow-up Study on the Complications, Body Mass Index Changes, Endoscopic Findings and Causes of Revision

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Abstract

Background

Bariatric surgery has been increasingly becoming popular due to the advancements in minimally invasive approaches and techniques. The aim of this study was to compare the long-term outcomes and clinical relevance of laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curvature plication (LGCP) in a matched controlled single-bariatric centre study.

Methods

We collected data from 163 patients who underwent either LSG or LGCP over a period of at least 5 years. The outcome parameters included body mass index (BMI) changes, causes of revision surgery, endoscopic findings and effects on obesity-related comorbidities.

Results

A total of 79 patients underwent LGCP, while 84 underwent LSG for morbid obesity. At the fifth year of follow-up, a BMI of < 30 was achieved in 1% of patients who underwent LGCP (n = 1) compared with more than 80% of patients who underwent LSG (n = 70). Revision was mainly due to gastroesophageal reflux disease (GERD) or bile reflux in the LSG group and due to weight gain in the LGCP group. LSG was superior in improvements in comorbidities. The most observed endoscopic finding was GERD (grade a, b) in the LSG group and unfolding of part of or the whole stomach in the LGCP group. Early minor postoperative complications occurred at a significantly lower frequency in the LSG group.

Conclusions

LGCP has a higher rate of complications, a much less durable effect on weight loss, a higher rate of revision surgery and a higher cost burden to the health care system than LSG.

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Author information

Author notes

  1. Mohamed Ibrahim, Mohamed Hany, Ahmed Zidan, Anwar Ashraf Abouelnasr and Ghada Ahmed Abu-Sheasha contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, 21561, Alexandria, Egypt

    Mohamed Ibrahim, Mohamed Hany, Ahmed Zidan & Anwar Ashraf Abouelnasr

  2. Department of Bio- Medical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt

    Ghada Ahmed Abu-Sheasha

Authors
  1. Mohamed Ibrahim
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  2. Mohamed Hany
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Correspondence to Mohamed Ibrahim.

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Key points

• LSG resulted in significant changes in terms of long-term BMI loss and fewer minor postoperative complications than LGCP.

• LGCP resulted in a significantly higher incidence of weight regain and the need for revisional surgery than LSG.

• The most commonly observed endoscopic finding was gastroesophageal reflux disease (GERD), grades a and b in the LSG group and the unfolding of part of or the whole stomach in the LGCP group.

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Ibrahim, M., Hany, M., Zidan, A. et al. Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Greater Curvature Plication: a Long-Term Follow-up Study on the Complications, Body Mass Index Changes, Endoscopic Findings and Causes of Revision. OBES SURG 31, 5275–5285 (2021). https://doi.org/10.1007/s11695-021-05683-5

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  • DOI: https://doi.org/10.1007/s11695-021-05683-5

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