Preliminary results with laparoscopic sleeve gastrectomy

Background: Sleeve gastrectomy represents the restrictive component of biliopancreatic diversion with duodenal switch (BPD-DS). Methods: From December 1, 2001 to November 30, 2004, we performed 11 laparoscopic sleeve gastrectomies (LSG) with a laparotomic duodenal switch during a single operating session, 36 isolated LSGs as a first-line procedure and 15 isolated LSGs following band removal (for intolerance or slippage). Results: There were no deaths amongst the 62 patients, but 3 patients presented with major complications: 1 case of stained-bile peritonitis (LSG associated with a cholecystectomy), 1 case of hemorrhage, and 1 case of gastric fistula. Average percentage of excess weight loss was 66.4 (range 37.3-90.9) at 1 year for primary LSG. Conclusion: LSG should be considered as a surgical option in the bariatric field. It can be performed either as a primary surgery to induce weight loss before a formal BPD-DS or as revisional surgery after gastric banding.