RESUMEN
BACKGROUND: Complications after bariatric surgery are not uncommon occurrences that influence the choice of operations both by patients and by surgeons. Complications may be classified as intra-operative, early (<30 days post-operatively) or late (beyond 30 days). The prevalence of complications is influenced by the sample size, surgeon's experience and length and percentage of follow-up. There are no multicentric reports of post-bariatric complications from India. OBJECTIVES: To examine the various complications after different bariatric operations that currently performed in India. MATERIALS AND METHODS: A scientific committee designed a questionnaire to examine the post-bariatric surgery complications during a fixed time period in India. Data requested included demographic data, co-morbidities, type of procedure, complications, investigations and management of complications. This questionnaire was sent to all centres where bariatric surgery is performed in India. Data collected were reviewed, were analysed and are presented. RESULTS: Twenty-four centres responded with a report on 11,568 bariatric procedures. These included 4776 (41.3%) sleeve gastrectomy (SG), 3187 (27.5%) one anastomosis gastric bypass (OAGB), 2993 (25.9%) Roux-en-Y gastric bypass (RYGB) and 612 (5.3%) other procedures. Total reported complications were 363 (3.13%). Post-operative bleeding (0.75%) and nutritional deficiency (0.75%) were the two most common complications. Leaks (P = 0.009) and gastro-oesophageal reflux disease (P = 0.019) were significantly higher in SG, marginal ulcers in OAGB (P = 0.000), intestinal obstruction in RYGB (P = 0.001) and nutritional complications in other procedures (P = 0.000). Overall, the percentage of complications was higher in 'other' procedures (6.05%, P = 0.000). There were 18 (0.16%) reported mortalities. CONCLUSIONS: The post-bariatric composite complication rate from the 24 participating centres in this study from India is at par with the published data. Aggressive post-bariatric follow-up is required to improve nutritional outcomes.
RESUMEN
BACKGROUND: Laparoscopic adjustable gastric banded plication (LAGBP) is a new restrictive bariatric procedure combining adjustable banding and greater curvature plication of the stomach. This study aimed to report the evolution of this surgical technique and analyze the surgical results. METHODS: Eighty patients who underwent LAGBP were enrolled in this study. The band-first technique was used in 50 patients from May 2009 to June 2011 and was then changed to the plication-first technique from July 2011 to October 2011. Patients' demographics and pre- and postoperative data, including complications and weight loss, were collected and analyzed. RESULTS: Eighty patients (26 men and 54 women) with a mean age of 30.75 ± 8.68 years and a mean body mass index of 38.05 ± 4.73 kg/m2 were evaluated with a mean follow-up of 10.52 (1-24) months. The average operation duration and hospital stay were 92.85 ± 35.86 min and 1.73 ± 1.04 days, respectively. No intraoperative complications or surgical mortality was observed in this series. Four (8%) postoperative complications occurred with the band-first technique and one (3%) with the plication-first technique. Mean excess weight loss (percentage) at 6, 12, 18, and 24 months were 42.59 ± 13.67, 56.38 ± 19.89, 57.59 ± 19.88, and 65.84 ± 17.36%, respectively. The frequency of band adjustment was 2.44 ± 2.21 times in 2 years. CONCLUSIONS: In this present 2-year result, LAGBP using plication-first technique revealed fewer complications and good weight loss. Longer follow-up is still necessary to be accepted as a stand-alone bariatric procedure.