Frequency of Early Complications of Laparoscopic Sleeve Gastrectomy Using Four Ports

TL;DR

This study examines early complications after laparoscopic sleeve gastrectomy using four ports and finds an 18% complication rate linked to higher BMI and longer surgery time.

Contribution

The study provides updated complication rates for four-port laparoscopic sleeve gastrectomy and identifies key risk factors.

Findings

Early complications occurred in 18% of patients, with bleeding, infection, and leakage each at 5%, 4%, and 3%.

Higher BMI and longer surgery duration were significantly associated with increased complication rates.

Reoperation was required in 5% of patients due to complications.

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) has become a widely accepted bariatric procedure for treating morbid obesity and associated comorbidities due to its relatively straightforward technique and positive outcomes in terms of weight loss and metabolic improvement.

Objective

To investigate the frequency and types of early complications following LSG using four ports.

Methods

This prospective observational study was conducted at Al Hadi International Hospital, Swabi, Pakistan, from January 2022 to December 2022. A total of 369 patients aged 25-65 years with a BMI of 35-55 kg/m2 were included. Data on demographic characteristics, surgery duration, intraoperative blood loss, and hospital stay were collected. Early complications within 30 days post-surgery, including bleeding, infection, and leakage, were documented. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).

Results

The mean age of patients was 43.6 years (SD = 11.8) and the mean BMI was 42.3 kg/m2 (SD = 6.5). The average surgery duration was 92 minutes (SD = 22) and the mean intraoperative blood loss was 100 mL (SD = 50). Early complications occurred in 18% of patients with bleeding, infection, and leakage each accounting for 5%, 4%, and 3%, respectively. Reoperation was required in 5% of patients due to these complications. Higher BMI (45.2 vs. 41.8 kg/m2, p = 0.04) and longer surgery duration (105 vs. 88 minutes, p = 0.03) were significantly associated with increased complication rates. Comorbidities were present in 60% of patients with complications compared to 34% without complications (p = 0.03).

Conclusion

The four-port technique in LSG is associated with an 18% early complication rate with significant risk factors being higher BMI and longer surgery duration. Careful patient selection, standardized surgical techniques, and robust postoperative care are essential to minimize complications and improve outcomes in LSG.

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