Benefits and Risks of Laparoscopic Gastric Surgery for Management of Morbidly Obese Patients

Background: Conservative management for obesity had limited role in treatment of obesity. Otherwise, surgical treatment is effective, But associated with many comorbidities. Aim of the work: To evaluate laparoscopic sleeve gastrectomy, greater curvature plication and gastric bypass in morbidly obese patients. Patients and Methods: Thirty patients were included. They were divided into three groups: A for laparoscopic greater curvature plication, B for laparoscopic sleeve gastrectomy, and C for laparoscopic gastric bypass. All subjects underwent full history taking, clinical examination, laboratory investigations, abdominal ultrasonography, and upper gastrointestinal endoscopy. Follow up carried out at the first two weeks then at 1, 3, 6, 12 months for late postoperative complications, changes in comorbidities (hypertension, diabetes mellitus, arthritis) and percentage of excess weight loss. Results: Studied groups were comparable as regard to patient demographics, preoperative comorbidities, intraoperative bleeding or postoperative complications. Operative time was significantly decreased in group B. EBWL differ significantly between groups at all postoperative follow up visits. For example at the second postoperative week, there was significant increase of EBWL in groups B and C when compared to group A (5.75±3.96 and 8.4±5.54 vs 1.15±0.81 respectively). Failure was 40%, 10% and 0% in groups A, B and C respectively. Only one patients died after operation in the bypass group. Morbidities were improved after surgery. Conclusion: Laparoscopic greater curvature plication, is lower than laparoscopic sleeve gastrectomy and laparoscopic gastric bypass surgery as the procedure for weight loss, despite of its less cost. In addition, it had higher complications, reoperations and weight gains.