Abstract

In Asia, the type and main cause of obesity is different than in western society. Therefore, the treatment plan should be differentiated, and the surgery for morbid obesity should be carefully chosen. The early results of laparoscopic sleeve gastrectomy (LSG) without duodenal switch that has been performed in the Korean population is reported. We retrospectively reviewed 130 patients who underwent LSG from January 2003 to May 2004. 60 of these patients now had >1 year of regular follow-up, and are the subject of this report. LSG was performed through 4 12-mm ports and 1 15-mm port, using the Endo-GIA stapler to create a lesser curve gastric tube over a 48-Fr bougie. For the 60 patients, the postoperative EWL was 71.6+/-21.9% at 6 months and 83.3+/-28.3% at 12 months. At 12 months after LSG, decrease in BMI was 9.2+/-3.7 kg/m2, and median weight loss was 24.6+/-10.0 kg. Dyslipidemia resolved in 75% of patients within 12 months. Diabetes resolved in 100% of patients within 6 months of operation. Hypertension resolved in 92.9% and improved in 100%. Joint pain resolved in 100% within 12 months. Weight loss plateaued at 12 months in the majority of patients. One patient has undergone a malabsorption procedure (duodenal switch) as a second-stage operation. Additional studies and follow-up are needed to determine the best surgical treatment for morbidly obese Asian patients. However, LSG without the second-stage duodenal switch operation has been an effective weight loss operation thus far, in most of the Korean patients.

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