Background: Laparoscopic sleeve gastrectomy (LSG) is a favorable bariatric procedure. This study evaluated the status of LSG in China.
Methods: During the 4th International Forum of Bariatric and Metabolic Surgery in May 2016, Nanjing China, an on-the-spot questionnaire was filled out by 105 attending surgeons with experience of LSG. The feedback data was collected and analyzed.
Results: For preoperative preparations, surgeons preferred blood glucose control with insulin (61.0%), bowel cleaning (33.3%), and fasting and water deprivation (75.2%). For surgical techniques, surgeons preferred 36/38F bougie (86.7%), greater curvature mobilization with ultrasonic energy device (89.5%), direct transection of short gastric vessels (80%), antrum resection within 2-6 cm to the pylorus (84.8%) with 4.8 mm height stapler (72.4%), and 3.5 mm for corpus (94.3%). Whole stapler-line reinforcement, gastric sleeve fixation, leaking test, and abdominal drainage were preferred by 48.6, 62.9, 39, and 47.6% surgeons. For postoperative managements, surgeons preferred nasogastric tube insertion (33.3%), early liquid diet (69.6%), 4 weeks of liquid diet (55.2%), 2000 ml daily water intake before discharge (79%), 4 weeks of PPI (69.5%), and multi-vitamin supplementation 1 week after operation (77.1%). For postoperative complications, preferences were tachycardia as the onset of leak (81.0%) and oral contrast radiography for leak diagnosis (72.4%). Leak managements include US-guided percutaneous drainage (68.6%), nasogastric tube (87.6%), and parenteral nutrition (61%). For prolonged leak, enteral nutrition (87.6%) and Roux-en-Y bypass (84.8%) as the salvage procedure were preferred. 95.2% preferred endoscopic dilation for stricture.
Conclusions: LSG is gaining its wide application in China, but standardization of LSG is urgently needed.
Keywords: China; Laparoscopy; Obesity; Sleeve gastrectomy; Survey.