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23190

Comparative Study between the Complications of Sleeve Gastrectomy versus the Complications of Gastric Bypass

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Last updated: 30 Jan 2023

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Abstract

Background: obesity means having too much body fat. Causes of obesity includes: diet, sugar overload, genetics, insufficient sleep, social determinants, environment, and stress. Complications of obesity includes: type II diabetes mellitus, heart diseases, metabolic syndrome, hyperlipidemia, respiratory diseases, male sexual dysfunction, neurological diseases, gastrointestinal diseases, rheumatic diseases, urological diseases, psychological abnormalities, trauma, pancreatic diseases, gall bladder diseases, diverticulitis and hernia. Sleeve gastrectomy is an excellent procedure for management of morbid obesity. Complications of Sleeve gastrectomy includes: Hemorrhage, leakage, nutritional deficiencies, ineffective EWL and weight regain, cholelithiasis, stenosis, gastroesophageal reflux disease GERD and hiatus hernia, gastric torsion, gastro-bronchial fistula and venous thrombosis. Complications with Roux-en-Y Gastric Bypass includes: Hemorrhage, leakage, nutritional deficiencies, ineffective excess weight loss EWL and weight regain, trocar site hernia, cholelithiasis, dumping syndrome, Internal hernia, obstruction of the biliopancreatic limb, intussusceptions volvulous, gastrogastric fistula, marginal ulceration and gastrojejunostomy anastomotic stricture. Aim:To compare complications associated with Sleeve Gastrectomy versus complications associated with open or laparoscopic Gastric Bypass and its effects on patients' life and to know which procedure is better. Patients and Methods: group (A): includes 15 cases underwent sleeve gastrectomy. With inclusion criteria of obese patients with body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2with associated co morbidity (hypertension, Diabetes mellitus, hyperlipidemia, arthritis, cardiac diseases, etc.) and exclusion criteria of patients with previous bariatric surgery, previous upper gastrointestinal surgery, hiatus hernias, heavy sweet eaters, drug and/or alcohol addiction, psychiatric disorders and patients >60 years old or <18 years old were excluded and group (B): includes 15 cases underwent gastric bypass with inclusion criteria of obese patients with body mass index (BMI) >40 kg/m2 or BMI > 35 kg/m2 with associated comorbidity (hypertension, Diabetes mellitus, hyperlipidemia, arthritis, cardiac diseases, etc.) and heavy sweet eaters and exclusion criteria of patients with previous bariatric surgery, previous upper gastrointestinal surgery apart from laparoscopic cholecystectomy. Patients with hiatus hernias, drug and/or alcohol addiction, psychiatric disorders and patients >60 years old or <18 years old were excluded. Results: three complications developed with sleeve gastrectomy 20% as follows 1 case of hemorrhage 6.6% , 1 case of leakage 66% and one case of gall bladder stones while gastric bypass complications resembles 2 cases 13.3% as follows:1case of deep venous thrombosis 6.6% and one case of gall bladder stones 6.6%. Conclusion: obesity is a common disease affecting more than 300 million adults worldwide. It is defined as a body mass index greater than 30 kg/m2. The laparoscopic sleeve gastrectomy was adopted as a primary procedure and over time it has become the most popular bariatric operation worldwide and it is effective for weight loss and results in improvement and even resolution of co-morbidities like type 2 diabetes.  Laparoscopic gastric bypass surgery is another safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently Recommendations: both sleeve gastrectomy SG and roux-en-y gastric bypass RYGB are safe, short, simple and effective bariatric operations. Our study showed Roux-en-y gastric bypass has less complication than Sleeve gastrectomy. Further prospective studies have to be applied to a larger number of patients for longer periods of follow up are needed.

DOI

10.21608/ejhm.2019.23190

Keywords

Obesity- Sleeve Gastrectomy- Roux-En-Y Gastric Bypass

Authors

First Name

Mohamed Fathy

Last Name

Sharaf

MiddleName

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Affiliation

Departments of General Surgery, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Eslam Taha

Last Name

Ghalwash

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Affiliation

Departments of General Surgery, Faculty of Medicine, Al-Azhar University

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City

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Orcid

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First Name

Mohammed

Last Name

Elkelany

MiddleName

Ali Abdelaty Awad

Affiliation

Departments of General Surgery, Faculty of Medicine, Al-Azhar University

Email

mohammedkelany1985@gmail.com

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-

Orcid

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Volume

74

Article Issue

3

Related Issue

4351

Issue Date

2019-01-01

Receive Date

2018-12-31

Publish Date

2019-01-01

Page Start

504

Page End

510

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_23190.html

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https://ejhm.journals.ekb.eg/service?article_code=23190

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6

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Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

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Article

Created At

22 Jan 2023