Laparoscopic sleeve gastrectomy versus laparoscopic gastric greater curvature plication: a prospective randomized comparative study

Abstract

Background Laparoscopic sleeve gastrectomy (LSG) involves resection of a significant portion of the stomach. Laparoscopic greater curvature plication (LGCP) is a relatively new alternative procedure similar to LSG, but without the need for gastric resection. Patients and methods Fifty patients fulfilled the National Institutes of Health criteria and were assigned randomly to receive either LGCP (n = 25) [16 women and nine men; mean age 32.1 years (19-49 years) and mean BMI 47.8 kg/m 2 (42-57 kg/m 2 )] or LSG (n = 25) [18 women and seven men; mean age 34.8 years (18-58 years) and mean BMI 46.8 kg/m 2 (41-55 kg/m 2 )] by a block randomization method. Patients were studied in terms of postoperative weight loss, changes in hypertension, HbA1c, and postoperative complications. Results All procedures were completed laparoscopically. Follow-up was 24 months. The mean hospital stay was 36 h (range 24-144 h) for both groups. No intraoperative complications occurred. Postoperatively, one case of minor leak was detected after LSG and two cases of stenosis following LGCP. All patients experienced postoperative excess weight loss and improvement in HbA1c. The improvement was significantly better in the LSG group in terms of the change in BMI (mean 14.45 compared with 10.35 in LGCP) and change in HbA1c (mean 1.2 compared with 0.5 in LGCP); the change in hypertension was not statistically significant. Conclusion LGCP is feasible, safe, and effective, but has an inferior weight-loss effect and is less effective in diabetes compared to LSG for morbidly obese patients with BMI above 40 kg/m 2 .