Long-term Outcomes of Laparoscopic Sleeve Gastrectomy from the Indian Subcontinent

Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed metabolic surgery worldwide. There are few mid- to long-term studies for LSG, especially from the Indian subcontinent.

Objective: The primary outcome of the study was percent total weight loss (%TWL), and secondary outcomes included type 2 diabetes mellitus remission (T2DM) rates, comorbidity resolution rates, revisional surgeries, and complications related to LSG, 3 and 5 years after surgery.

Method: The study was a single-center, retrospective analysis from patients who underwent primary as well as revisional LSG between January 2012 and December 2013 from a tertiary care center in India. We included patients who completed a minimum follow-up of 5 years. Details of the patients were collected from outpatient and inpatient case sheet records, during their follow-up.

Results: Out of a total of 284 patients, 57% were females. Mean baseline body mass index (BMI) was 44.9 ± 7.9 kg/m. The diabetic population comprised 14.8% of the total patients. Mean %TWL at 5 years was 26.0 ± 9.9%. T2DM remission at 1, 3, and 5 years were 78.5%, 71.4%, and 66.6%, respectively. Preoperative BMI (p = 0.02), glycosylated hemoglobin (HbA1c) (p = 0.04), duration of diabetes in years (p = 0.04), and preoperative insulin usage (p = 0.04) were the preoperative predictors for T2DM remission. Early (< 30 days) and late (> 30 days) complications were seen in 4.5% and 0.7% of the population, respectively.

Conclusion: Weight loss after LSG was maintained in the majority of the patients, while a small proportion has significant weight regain at 5 years. T2DM resolution and other comorbidity resolutions were well supported after LSG.