April - June 2008, Volume 4, Issue 2

Iordache N, Copaescu C, Litescu M, Munteanu R, Boru C, Badiu C, Stoica A

Bariatric surgery evolution in Romania. Results 1 year after a variety of bariatric procedures

Acta Endo (Buc) 2008, 4 (2): 161-172
doi: 10.4183/aeb.2008.161

Obesity is a worldwide public health problem (both in developed and developing countries), the most frequent nutritional disease in the world, with considerable morbiditymortality and high costs for the public healthcare systems. Bariatric surgery has been found to be the only method capable of maintaining proper and long-lasting weight loss for morbid obesity. Laparoscopy is the gold standard for bariatric procedures. We studied a group of 341 patients who underwent different types of laparoscopic bariatric surgical procedures: laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), laparoscopic gastric bypass (LGB) and laparoscopic biliopancreatic diversion (LBPD). They were evaluated preoperative (weight, BMI, comorbidities) and followed-up for 1 year: 238 patients LAGB, 46 LSG, 49 LGB and 8 LBPD. Mortality and conversion rate were nil for all groups. A significant reduction in patients’ weight was shown at 12 months postoperatively. BMI decreased from 45.6 kg/m2 to 37.9 for LAGB, from 54.12 to 40.8 kg/m2 for LGB and from 49.1 to 31.2 kg/m2 for LSG. The excess weight loss for LBPD was 63%. A significant improvement of co-morbidities was noticed; all patients with type 2 diabetes have normal serum glucose levels at 1 year after surgery. Bariatric surgery is safe with a low complication rate and the outcome was similar to literature data. Although we do not benefit of a long time follow-up, the favorable results allow us to state that minimally invasive surgical techniques deserve an important place in the efforts of struggling against obesity and its consequences.

Keywords: obesity, laparoscopy, bariatric surgery, gastric banding, sleeve gastrectomy, biliopancreatic diversion, gastric by-pass

Correspondence: Niculae Iordache Sf. Ioan Hospital, Surgery Department, 13 Vitan-Barzesti Bucharest, Romania, e-mail: nicolae_iordache@yahoo.com