Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Greater Curvature Plication: a Long-Term Follow-up Study on the Complications, Body Mass Index Changes, Endoscopic Findings and Causes of Revision.

Abstract

Bariatric surgery has been increasingly becoming popular due to the advancements in minimally invasive approaches and techniques. The aim of this study was to compare the long-term outcomes and clinical relevance of laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curvature plication (LGCP) in a matched controlled single-bariatric centre study. We collected data from 163 patients who underwent either LSG or LGCP over a period of at least 5years. The outcome parameters included body mass index (BMI) changes, causes of revision surgery, endoscopic findings and effects on obesity-related comorbidities. A total of 79 patients underwent LGCP, while 84 underwent LSG for morbid obesity. At the fifth year of follow-up, a BMI of < 30 was achieved in 1% of patients who underwent LGCP (n = 1) compared with more than 80% of patients who underwent LSG (n = 70). Revision was mainly due to gastroesophageal reflux disease (GERD) or bile reflux in the LSG group and due to weight gain in the LGCP group. LSG was superior in improvements in comorbidities. The most observed endoscopic finding was GERD (grade a, b) in the LSG group and unfolding of part of or the whole stomach in the LGCP group. Early minor postoperative complications occurred at a significantly lower frequency in the LSG group. LGCP has a higher rate of complications, a much less durable effect on weight loss, a higher rate of revision surgery and a higher cost burden to the health care system than LSG.