PL-33: Sleeve Gastrectomy with Enteral Bypass (SGEBP), new technique for morbid obesity: 3 years follow-up

Background: The authors present a new restrictive and malabsorptive operation for treatment of morbid obesity, called Sleeve Gastrectomy with Enteral Bypass (SGEBP) Methods: From Feb 2004 to July 2007, 91 patients with BMI 40 kg/m2 or 35 kg/m2 with co-morbidities underwent SGEBP via laparoscopy or laparotomy. The technique consisted in creation of gastric tube preserving pylorus (Sleeve Gastrectomy), and a Rouxen-Y limb of 300 cm of the proximal small bowel starting 30 or 40 cm from the ligament of Treitz (enteral bypass). Excess weight loss (EWL), BMI, complications and co-morbidities were assessed. Results: BMI and average preoperative weight were 40,6 kg/m2 and 108,4 kg, respectively. At 36 months postoperatively, BMI and average weight were 26,6 kg/m2 and 73,2 kg, respectively, with EWL 71.5%. None of the patients presented dumping. Improvement in co-morbidities was 90%. No mayor complication was reported, diferent than those described in others bariatric techniques (hemoperitoneum, cholelytiasis, gastric tube leak, etc.). None of the patients present hepatic insuficiency or malnutrition. There was no mortality. Conclusion: SGEBP has thus far been safe and effective, with at least the same results as other bariatric operations, but with many advantages, such as lack of Dumping. Because a duodenal bypass is not performed, it allows physiologic absorption of iron and diagnostic and/or therapeutic access to the ampulla of Vater. However the main advantage is the better results compared to Sleeve Gastrectomy alone.