Results and complications of gastric partitioning. Four year follow-up of 300 morbidly obese patients.

ABSTRACT

Two-hundred seventy-seven morbidly obese patients were followed 6 to 48 months through three modifications of gastric partitioning. Technical failures caused poor results in 75 percent of patients in Groups I and II. Group III patients were operated on using a single TA-90 application with three midlateral staples removed. The proximal staple line was reinforced by a row of interrupted 2-0 silk sutures and a circumferential 1-0 silk suture supported with Teflon pledgets around the stoma. This technique effected good or excellent weight loss in 70 percent of the patients. Complications were minimal except for stomal dilatation through the gastroscope required in 22 percent of the patients and staple line disruption despite reinforcing maneuvers in 7 percent. Because of the dilatations and the 7 percent technical failure, I recently adopted the vertical gastroplasty as described by Eckhout and Prinzing [5]. Long-term follow-up by an experienced team consisting of a surgeon, gastroenterologist, dietition, and supportive staff is essential for the continued success of the surgical management of the morbidly obese patient.