Evaluation of Laparoscopic Combined Sleeve Gastrectomy and Mini-Gastric Bypass in Treatment of Morbid Obesity | ||||
| The Medical Journal of Cairo University | ||||
| Article 80, Volume 86, September, September 2018, Page 2791-2799 PDF (421.64 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2018.59620 | ||||
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| Authors | ||||
| AHMED M. AL-GHAMERY, M.Sc.; SHERIF A. SABER, M.D.; AHMED A. EL-SHOURA, M.D.; HAMDY S. ABDALLAH, M.D.; GAMAL I. MOUSSA, M.D. | ||||
| The Department of Gastrointestinal, Liver and Laparoscopic Surgery, Faculty of Medicine, Tanta University | ||||
| Abstract | ||||
| Abstract Background: Combined sleeve gastrectomy and MGB is a modified bariatric procedure composed of the standard procedures of sleeve gastrectomy and MGB that can be performed by laparoscopic technique. This combined procedure is still a novel technique with assumed beneficial effects based on the theory and former experiences with both techniques individually. Aim of Study: Assessment of the efficacy of combined sleeve gastrectomy and MGB in treatment of morbidly obese patient as regard weight reduction and control of co-morbidities. Patient and Methods: From January 2016 to January 2018, laparoscopic combined sleeve gastrectomy and MGB was performed in 20 patients at the Gastrointestinal Surgery Unit, General Surgery Department, Tanta University, Egypt. Results: The study population included 18 females and 2 males with a mean age of 33.13±7 years. The mean pre-operative Body Mass Index (BMI) was 54. 13±60kg/m2. All procedures were completed laparoscopically. Comorbidities: The mean operative time was 153±27.7 minutes and the mean postoperative hospital stay was 6.1±5.8 days. Early compli-cations were encountered in 4 cases (20%) including 3 port site infections (15%), stable line leakage 5 days after operation was recorded in 1 case (5%). Late complications included 6 cases (30%). Pre-operative obesity related co morbidities; hypertension in 2 cases, diabetes mellitus in 3 cases, Dyslip-idaemia in 4 cases and arthrealgia in 7 cases. The mean BMI 18 months after surgery was 29.23±3.4kg/m2, and the EWL% ranged between 51.45% and 98.2% with a mean of 80.68±10.55 18 months after operation. Most of the co-morbidities improved or resolved; 100% for hypertension and diabetes mellitus, 75% for dyslipidemia and 71.4% for artheralgia. Conclusion: Despite the short duration of follow-up for most of the patients, combined SG and MGB can be considered an effective surgical procedure for treatment of morbid obesity in terms of weight reduction and control of co-morbidities. A higher cost is expected for this procedure due to the larger number of cartridges used. Like other bariatric procedures, this novel procedure was attended with post-operative complications mainly staple line leakage, biliary reflux, stomal ulcer, nutritional deficiencies and symptomatic gallbladder stones. | ||||
| Keywords | ||||
| Obesity – Sleeve gastrectomy – Mini-gastric-bypass | ||||
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