Laparoscopic gastric plication in patients with type 2 diabetes mellitus. Our 3 years follow-up

Abstract

Aim. Studying long term results after laparoscopic gastric plication during 3 years of follow-up. Material and Methods. From November 2009 to April 2012 we performed 29 laparoscopic gastric plications in patients with type 2 diabetes mellitus. Prior to operation, all patients were informed about the nature of operation and gave voluntary consent to its implementation. The main inclusion criteria were the criteria approved by the American Association of Metabolic and Bariatric Surgeons (ASMBS)- BMI over 40 kg/m2 or more than 35 kg/m2 in the presence of metabolic syndrome. All patients were treated by dietitian for 6 months prior to surgery with no significant effect. Results and Discussion. Mean preoperative weight was 141±6,2 kg, BMI 47±1,3 kh/m2. Duration of operation ranged from 90 to 180 minutes, mean 115 ± 17 min. Mean percentage of EWL was 35 ± 5% at 6 months, 49 ± 7% at 1 year, 59 ± 3% at 2 years and 52 ± 5% after 3 years of follow-up. We also observed =complete remission of diabetes in 13 patients (45%), partial in 9 (31%) and lack of remission in 7 (24%) patients after three years of follow-up. Conclusions. Pathogenetic mechanisms of the influence of gastric plication on obesity in patients are similar to vertical resection of the stomach. However, laparoscopic gastric plication substantially reduces and in many cases eliminates appearance of such dangerous complications as stapler line leaks and bleeding from stomach. Further study of the gastric plication influence will allow implementing this technique in bariatric surgery practice for treatment of patients with metabolic syndrome.

Keywords

• gastric plication, bariatric surgery, type 2 diabetes mellitus, obesity, metabolic syndrome