Previous gastric banding increases morbidity and gastric leaks after laparoscopic sleeve gastrectomy for obesity

Abstract

Undergoing first-line gastric banding increases the risk of complications after secondary LSG. We recommend that patients who undergo LSG after a first-line gastric banding should be warned of the increased risks of morbidity or, alternatively, that LSG be performed preferentially as the initial procedure.

State of the Art: Sleeve Gastrectomy

“…According to two recent systematic reviews, buttress materials are not able to reduce leakage [12,31]. In experienced hands, the leakage rate is below 1% [14,33], on average 1% (±1.13%) [28], going up as high as 16% in patients after LSG as a redo procedure [34]. The first clinical signs of a leak may be tachycardia, fever or pain.…”

Previous Bariatric Surgery Increases Postoperative Morbidity after Sleeve Gastrectomy for Morbid Obesity

“…compared to other multicenter trials such as the nationwide German survey which reported a 7% rate (9). In order to reduce postoperative leakage, some authors suggest a controversial management of the preoperative, the surgical or the postoperative period : revisional bariatric surgery, sizing sleeve with or without a bougie, staple height, landmark for the first firing, antrum resection, staple line reinforcement with running suture, oversewing or not, use of buttressing material, postoperative nasogastric tube for decompression, upper gastrointestinal Gastrografin ® study on postoperative day 1 or later and postoperative diet… (2,6,8,11,12,13,14).…”

Analysis of Morbidity Data of 308 Cases of Laparoscopic Sleeve Gastrectomy—the Soroka Experience

“…On the other hand, Iannelli [21] reported some increased risk for post-secondary LSG complications and was followed in by others [20,[22][23][24][25][26][27][28]. Gagniere et al [24] reported a series of 102 patients undergoing primary or secondary LSG, with significantly higher risk for complications in the secondary LSG group.…”