Laparoscopic Gastric Greater Curvature Plication: Intermediate Results and Factors Associated with Failure

Laparoscopic gastric greater curvature plication (LGGCP) is a novel bariatric procedure. Few studies have presented intermediate or long-term results. The aim of this prospective study was to investigate intermediate results and factors associated with failure to achieve satisfactory weight loss after LGGCP.

Between October 2011 and November 2013, 61 patients underwent LGGCP and were followed up to 36 months after operation. Demographics, comorbidities, complications, and percentage of excess body mass index loss (%EBMIL) were analyzed. Logistic regression analysis was used to determine independent risk factors for weight loss failure 3 years after LGGCP.

Forty-eight women and 13 men with an average age of 47.7 ± 10.3 years and preoperative BMI of 46.3 ± 5.8 underwent LGGCP. Postoperative complications were observed in three patients (4.9%) and two of them (3.3%) underwent reoperations. Follow-up rate was 95%, 91.7, and 88.3% after 1, 2, and 3 years, respectively. Average %EBMIL after 1 year was 47.25 ± 21.6, 44.8 ± 25.9 after 2 years, and 41.9 ± 25.6 after 3 years. Gastroscopy 3 years after LGGCP demonstrated intact plication fold in 55% of cases. Preoperatively, GERD was present in 46% of patients. Prevalence of GERD 3 years after LGGCP was 34.6%. Remission rates of type 2 diabetes mellitus and hypertension were 27.8 and 38.3%, respectively. Higher postoperative hunger sensation was found to be an independent factor (OR 1.6, 95% 1.141-2.243; p = 0.002) associated with unsatisfactory weight loss after LGGCP.

Patients with LGGCP had postoperative complication rate 4.9% and achieved only modest weight loss after 3 years. Increased hunger was an independent risk factor associated with unsatisfactory weight loss after LGGCP. Long-term follow-up data are needed to define the role of LGGCP in the treatment of morbid obesity.