Incidence of adhesions in patients using liraglutide before laparoscopic sleeve gastrectomy

The current study objectively identified the incidence of adhesions between the stomach and pancreas in laparoscopic sleeve gastrectomy (LSG) patients on liraglutide (cases group) and off (control group) liraglutide.

This observational prospective study was conducted in the Department of General Surgery at Saudi German Hospital, Al-Aseer, Saudi Arabia (SGH) after approval by the Institutional Review Board. 117 patients with prior use of liraglutide and 101 patients with no liraglutide use scheduled for LSG over 12 months were included. Inclusion criteria included patients undergoing LSG with or without prior use of liraglutide. Exclusion criteria included patients with prior abdominal surgeries, bariatric surgery revisions, prior upper GI scope showing gastritis, Gastroesophageal Reflux Disease (GERD) or any other pathology, and other known causes of other causes of pancreatitis. Using laparoscopy obtained imaging during LSG cases adhesions between the posterior stomach and pancreas were identified.

The mean age of the patients in the cases and control groups was 32.44 ± 9.90 years and 28.23 ± 8.48 years (p = 0.001). The mean BMI of patients in the cases and control groups was 43.56 ± 4.59 and 45.00 ± 4.78, respectively (p = 0.024). 85% of the patients were females, while 17.0% were males in the cases group. 53.5% of the patients were females, while 47.0% were males in the control group (p < 0.001). In the cases group, 48.7% of patients had stopped liraglutide for no obvious reason. Under the cases group, 77.8% of the patients had no adhesions, while 22.2% had adhesions. Under the controls group, no adhesions were seen (p < 0.001).

Our results for the first time demonstrate an incidence of adhesions in 22.2% of patients undergoing LSG on prior liraglutide intake (p < 0.001). This study brings to light the possibility of adhesions in patients with prior exposure to liraglutide undergoing LSG. Surgeons performing LSG in patients with prior exposure to liraglutide should be cognizant of this possibility, thereby requiring careful meticulous dissection.