Assessment of Late Complications after Laparoscopic Sleeve Gastrectomy for Morbid Obesity Patients

Background: Despite laparoscopic sleeve gastrectomy's (LSG) success as a surgical treatment for morbid obesity, complications are not uncommon and can have serious consequences, including patient death. Objective: To report late complications of LSG that may be encountered after one month, including stricture, nutritional complications, and gastroesophageal reflux disease (GERD). Subjects and Methods: At General Surgery Department, Zagazig University Hospitals, 18patients were involved in our prospective cohort study, they were obese with body mass index (BMI) exceeding 40kg/m2 or BMI exceeding 35kg/m2, and associated comorbidities such as hypertension and diabetes mellitus (DM). Results: More than fourth (27.7%) of the patients were positive GERD. No mortality was reported among them, 16.7% of cases were positive gall bladder stones (GBS). Two cases (11.1%) suffered from hiatus hernia. Post-operatively, there was a considerable drop in BMI, the mean baseline BMI of cases group was 47±1.85 ranging from 44 to 50, the mean post-operative BMI after 6months became 36.78±2.67 and the mean BMI after 1year reached 31.61±2.99kg/m2 and significant increase in percentage of weight loss after operation was observed. About 2/3 (64.3%) of DM cases showed full remission and 35.7% of cases were good DM controlled. Conclusion: Laparoscopic sleeve gastrectomy is a simple surgical procedure resulting in low rate of late complication with insignificant long-term nutritional deficiencies, especially when compared to the other alternatives. General surgeons should have understood of the complications associated with LSG and an approach for dealing with them. Late complications include strictures, nutritional deficiencies, and GERD.