Cause analysis and treatment of the complications after laparoscopic sleeve gastrectomy in 200 cases

Abstract

Objective To investigate the causes and management of complications after laparoscopic sleeve gastrectomy (LSG). Methods Clinical data of 200 obese patients undergoing LSG in the First Affiliated Hospital of Jinan University between April 2007 and May 2015 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 200 patients, 40 were males and 160 were females with an average age of (30±10) years old and an average body mass index of (37±6) kg/m2. The surgical situation was recorded for each patient, and they were followed-up at 1, 3, 6 and 12 month postoperatively and then yearly thereafter, up to May 2017. The contents of follow-up included body weight, blood glucose, blood biochemical indexes, improvement of metabolic and nutritional indicators and remission of obesity-related complications and surgical complications. Results All patients received LSG successfully without conversion to laparotomy. After operation, gastric tangential bleeding occurred in 1 case, gastroesophageal reflux disease in 1 case, gastric fistula in 1 case, recurrent severe vomiting in 1 case, hiatal hernia in 2 cases and weight loss failure in 1 case; however all these complications were improved or cured by conservative or operative treatments. Conclusions Most of the complications occurred after LSG are related to unsuitable procedure during LSG, early and accurate diagnosis and postoperative correct management are meaningful for treating LSG complications, and the complication prevention always comes first. Key words: Obesity; Laparoscopic sleeve gastrectomy; Complication