A Comparative Study of the Results of Three cm versus Six Cm Distance from Pyloric Sphincter in Sleeve Gastrectomy

Abstract

Background: Obesity is excessive fat accumulation. Now, laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a primary, staged and provisional operation for its proven safety and simplicity. Complete removal of the gastric fundus makes adequate weight loss and plays a key role in reducing co-morbidities, ghrelin production, and eliminate inlet of the stomach to become small enough so that the patient will feel full quickly. Objective: The aim of this study was to assess the results of resecting the stomach 6-cm versus 3-cm from the pylorus regarding weight loss, reflux development, nausea and vomiting Patients and Methods: This randomly selected prospective study included a total of 30 morbidly obese patients, attending at Department of General Surgery, Bab El-Shaaria, and Al-Azhar University Hospital for doing sleeve gastrectomy. According to the starting point of stomach resection, the included subjects were randomly divided into two groups; each was 15 patients. Group (A) started 3 cm from the pylorus towards the gastro-esophageal junction and Group (B) started 6 cm from the pylorus. These patients followed up over a period of 2 years for postoperative nausea; vomiting and reflux symptoms and their weight loss. Results: group A patients (3 cm groups) were >14 times at a higher risk to have minor complications in the form of nausea; vomiting and reflux compared to group B patients (6 cm groups) without any difference between both groups regarding BMI changes over a period of six months. Conclusion: It could be concluded that leaving an antral pouch of 6 cm size while performing this procedure is recommended for better outcome with minor complications.