Feasibility And Efficacy Of Laparoscopic Sleeve Gastrectomy As A Revisional Procedure After Failed Gastric Plication In Morbidly Obese Patients

Background:Failure of adequate weight loss or weight regain has been reported after laparoscopic greater curve plication (LGCP). The primary aim of this retrospective study is to analyze weight loss outcome after revision of failed LGCP into laparoscopic sleeve gastrectomy (LSG). Patients and Methods:Patients who experienced failure (insufficient weight loss/weight regain) after LGCP performed in our center from 2009 to 2012 were included. LSG was performed for all patients. Results:Among 127 who underwent LGCP, 42 patients (33%) underwent revision. Mean body mass index (BMI) at time of LGCP was 44 +/- 6 kg/m(2). The highest % total weight loss (%TWL) after LGCP ranged from 11% to 34% (24.1 +/- 5) (corresponding to % excess weight loss [%EWL] of 12%-47% [33.5 +/- 12]). The time interval between LGCP and LSG ranged from 12 to 25 months (15.4 +/- 3.8). After conversion, 2 patients (5%) experienced acute leakage managed by endoscopic stenting. After LSG, mean BMI (kg/m(2)) was 38, 32, 30, 28, 29, 30.2, and 30.4, while mean %TWL reached 9%, 19%, 24%, 29%, 25%, 25%, and 24% and mean %EWL reached 15%, 51%, 69%, 77%, 68%, 66%, and 64% at 1 month, 6 months, 1, 2, 3, 4, and 5 years, respectively. Except for results at 1 month, all results showed statistical significance (P <= .05). After LSG, the incidence of diabetes mellitus and hypertension dropped from 15 (35%) and 13 (30%) to 2 (5%) and 3 (7%) patients, respectively. No follow-up data (0%) were missed. Conclusion:LSG after failed LGCP has promising weight loss outcomes.