THE IMPACT OF THE BOUGIE SIZE AND THE EXTENT OF ANTRAL RESECTION ON WEIGHT-LOSS AND POSTOPERATIVE COMPLICATIONS FOLLOWING SLEEVE GASTRECTOMY : RESULTS FROM THE SCANDINAVIAN OBESITY SURGERY REGISTRY

• Background: Laparoscopic sleeve gastrectomy (LSG) as a primary bariatric procedure has gained increasing popularity world-wide. However, controversies still exist regarding several operative aspects, such as the optimal diameter of thesleeve and the optimal distance from the pylorus to the edge of the resection line, and whether these aspects haveeffects on weight-loss results and the risk to develop postoperative complications.Objective: The aim of this study was to compare weight-loss results and the incidence of postoperative complications betweensleeve with different diameters measured in bougie size and with different distances from the pylorus to the edge ofthe resection line measured in centimeter.Setting: Nationwide registry-based study.Method: This study is an analysis of sleeve gastrectomy performed in Sweden between 2012 and 2019. Data were collectedfrom Scandinavian Obesity Surgery Registry (SOReg). Patients with bougie size 30-32 and 35-36 and patients withdistance from pylorus 1-4 cm, 5 cm, 6-8 cm were identified and compared regarding weight-loss results and the riskto develop postoperative complications.Results: 9,360 patients were included. Follow-up rate was 96% at day 30, 78.8% at one year and 50% at two years. Bothbougie size 30-32 compared to 35-36 and distance from the pylorus 1-4 cm compared to 5 cm were associated withsignificant higher weight-loss at one and two years. No difference in the risk for early or late complications was seenbetween bougie size groups 30-32 and 35-36. Resection starting 1-4 cm from the pylorus compared to 5 cm was as-sociated with higher risk for overall early postoperative complications (OR 1.46 (1.17-1.82, P=.001)), but there wasno significant difference in the risk to develop late complication at 1 and 2 years. No difference in the leak rate andin the risk to develop stricture was seen between different Bougie sizes, nor distances from the Pylorus.Conclusion: Using a smaller Bougie size and starting the resection closer to the pylorus was associated with better maximumweight-loss. Closer resection to the Pylorus, but not Bougie size was associated with increased risk for early postop-erative complications after sleeve gastrectomy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Publication and Content Type

vet (subject category)

art (subject category)