Laparoscopic Sleeve Gastrectomy versus Greater Curve Plication in Management of Morbid Obese Patients with Hiatus Hernia

Abstract

Introduction and Aim: Laparoscopic sleeve gastrectomy (LSG) considered the gold standard for management of morbid obesity, but, it has serious complications. Laparoscopic greater curvature plication (LGCP) is a restrictive procedure to lower the complications of LSG with the advantage of being a reversible procedure. The current work was designed to compare between Laparoscopic sleeve gastrectomy and greater curve plication in management of morbid obese patients with hiatus hernia.
 Methodology: This study included 40 morbidly obese patients with hiatal hernia, who underwent laparoscopic Nissen Fundoplication with Greater Curvature Plication (Group A) or Laparoscopic Crural Repair with Sleeve Gastrectomy (Group B).
 Results: Vomiting was the most common postoperative complaint. Two out of 20 patients (10%) In cases of LGCP developed prolonged nausea, vomiting and sialorrhea for 5 and 7 days but subsided subsequently with antiemetics, proton pump inhibitors, and prokinetics. Intraoperative hemorrhage in two cases of LGCP, Two out of 20 patients (10%) In cases of LGCP developed prolonged nausea, vomiting and sialorrhea for 5 and 7 days but subsided subsequently with antiemetics, proton pump inhibitors, and prokinetics. Four patients of 20 patients (20%) In cases of LGCP developed weight regain and sleeve gastrectomy revision was obtained by performing re-laparoscopy.
 Conclusion: LSG is a better procedure than LGCP as the most important disadvantage of Laparoscopic gastric plication are that it causes a high rate of recurrence and occurrence of early postoperative complaints.