Operative morbidity of laparoscopic sleeve gastrectomy in subjects older than age 65

Continuous developments in healthcare have led to an increase in average life expectancy. Obesity in aged persons is increasing and is more clearly associated with an increased risk of diabetes, cardiovascular disease, lipid abnormalities, mobility-limited problems, and other co-morbidities in this category of age.

The aim of the present study was to report the outcomes of laparoscopic sleeve gastrectomy in patients >65 years of age.

Private hospital, France.

A retrospective review was performed from patients aged >65 years who had undergone laparoscopic sleeve gastrectomy (June 2011-December 2017). The data analyzed included age, co-morbidities, preoperative body mass index, length of hospital stay, and postoperative complications.

A total of 93 patients were included with a mean age of 68.8 years (range, 65-78); 73 were female (78.5 %), and the mean preoperative body mass index was 43.6 ± 5.4 kg/m². Revisional surgery was well represented in 34.4% of cases. Thirty-two patients had a previous gastric band converted to laparoscopic sleeve gastrectomy, with 12 cases of 1-step revision (37.5%). Eleven patients (11.8%) had concomitant cholecystectomy. All procedures were performed laparoscopically with no peroperative complications. The median hospital stay was 3.1 days (1-6 d). Complications included 1 hematoma treated conservatively. The 30-day mortality rate was 0%. The mean excess weight loss at 1 year postoperatively was 67.1% (range, 34%-107%) with a follow-up rate of 78.1%. Resolution or improvement was observed in 65% of patients presenting with diabetes, in 72.5% of patients presenting with HTA, in 47.1% of patients presenting with dyslipidemia, and in 63.6% of patients presenting with sleep apnea.

Sleeve gastrectomy in elderly patients seems to be safe in terms of complications. Surgery is associated with a low-morbidity profile. Sleeve gastrectomy is our preferred procedure in this category of patients.