Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience

Abstract

BACKGROUND: Long-term data of laparoscopic sleeve gastrectomy (LSG) are still scarce in the Middle East. OBJECTIVES: The aim of this study was to assess the efficacy and safety at 5 years and beyond. SETTING: Tertiary referral hospital between April 2007 and March 2015. METHODS: A retrospective review of 76 patients who underwent LSG at the senior author's institution between April 2007 and March 2010. RESULTS: Mean preoperative body mass index (BMI) was 42.8+/-7.1 kg/m(2). Follow-up rates were 90.4%, 86.3%, and 77.8% at 5, 6, and 7 years, respectively. Percentage of excess weight loss (%EWL) was 69.8%+/-28.7% at 5 years, 70.6%+/-32.7% at 6 years, and 76.6%+/-21.2% at 7 years, respectively. Mean total weight loss was 26.5%+/-8.7%, 24.9%+/-8.8%, and 26.6%+/-6.0% at 5, 6, and 7 years, respectively. %EWL at 5-years was significantly higher for patients with a preoperative BMI<45 kg/m(2) (83.1% versus 46.3%, P<.0001). LSG improved or resolved diabetes, hypertension, and asthma in 87.5%, 68%, and 81.7% of patients, respectively. New onset gastroesophageal acid reflux disease developed in 21.2% of patients. Long-term complications included hiatal hernias necessitating repair (1.4%), incisional hernias (2.7%), and symptomatic gallstones (9.6%), as well as depression necessitating admission (4.1%). CONCLUSION: In the present patient population, LSG resulted in satisfactory %EWL and co-morbidity resolution after 5 years. The results were excellent for patients with a BMI<45 kg/m(2). De novo acid reflux symptoms developed in 1 of 5 patients. Cholelithiasis necessitating cholecystectomy was the most common long-term complication.