Original article| Volume 14, ISSUE 10, P1480-1487, October 2018

10-year follow-up after laparoscopic sleeve gastrectomy: Outcomes in a monocentric series


      • Sleeve gastrectomy long term outcomes are scarce and generally do not exceed 5 years.
      • Baseline BMI significantly and linearly predicts the %EWL at 10 years.
      • Sustained weight loss and resolution of comorbidities are observed up to 10 years.
      • Weight regain does not impact negatively on comorbidity remission/improvement rates.



      Sleeve gastrectomy (SG) has grown into the most popular bariatric operation. Nevertheless, a scarcity of long-term outcomes are available.


      This study aims at evaluating the long-term percent weight loss (%WL), excess weight loss (%EWL), weight regain (WR), and co-morbidity resolution rates in a single-center cohort undergoing SG as a primary procedure, with a minimum 10-year follow-up.


      University hospital, Italy.


      One hundred eighty-two morbidly obese patients with body mass index (BMI) 46.6 ± 7.3 kg/m2 underwent SG. Obesity-related co-morbidities (type 2 diabetes, hypertension, sleep apnea, gastroesophageal reflux disease) were investigated. Predictors of dichotomous dependent-variable diabetes remission were computed using a binomial logistic regression.


      Patient retention rate was 77%. Mean %WL was 30.9, %EWL was 52.5%, and WR (≥25% maximum WL) occurred in 10.4%. Baseline BMI significantly (P = .001) and linearly predicted %EWL (10 yr %EWL = 18.951 + initial BMI × .74); the super-obese subgroup generated substantially greater WL compared with those with BMI <50 kg/m2 (%EWL 48.0 ± 18.5 versus 61.5 ± 23.2; P < .001). Type 2 diabetes remission occurred in 64.7%; 42.9% patients developed de novo gastroesophageal reflux disease symptoms postoperatively (P < .0001).


      SG generates sustained WL and co-morbidity resolution up to 10 years postoperatively. Although a notable portion of patients experience WR, mean %WL persists to exceed 30%, translating in adequate WL also in the long term. Additionally, WR does not seem to impact negatively on co-morbidity resolution. SG represents a safe and effective bariatric operation, which easily grants the possibility to proceed to revisional bariatric surgery in patients with WR or failure to WL.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery for Obesity and Related Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Puzziferri N
        • Roshek TB
        • 3rd MayoHG
        • Gallagher R
        • Belle SH
        • Livingston EH
        Long-term follow-up after bariatric surgery: a systematic review.
        JAMA. 2014; 312: 934-942
        • Khorgami Z
        • Shoar S
        • Andalib A
        • Aminian A
        • Brethauer SA
        • Schauer PR
        Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates.
        Surg Obes Relat Dis. 2017; 13: 774-778
        • Ž Juodeikis
        • G Brimas
        Long-term results after sleeve gastrectomy: a systematic review.
        Surg Obes Relat Dis. 2017; 13: 693-699
        • Diamantis T
        • Apostolou KG
        • Alexandrou A
        • Griniatsos J
        • Felekouras E
        • Tsigris C
        Review of long-term weight loss results after laparoscopic sleeve gastrectomy.
        Surg Obes Relat Dis. 2014; 10: 177-183
        • Basso N
        • Casella G
        • Rizzello M
        • et al.
        Laparoscopic sleeve gastrectomy as first stage or definitive intent in 300 consecutive cases.
        Surg Endosc. 2011; 25: 444-449
        • Casella G
        • Soricelli E
        • Giannotti D
        • et al.
        Long-term results after laparoscopic sleeve gastrectomy in a large monocentric series.
        Surg Obes Relat Dis. 2016; 12: 757-762
        • Soricelli E
        • Casella G
        • Di Rocco G
        • Redler A
        • Basso N
        Longitudinal sleeve gastrectomy: current perspectives.
        Open Access Surgery. 2014; 2014: 35-46
        • Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery
        Updated position statement on sleeve gastrectomy as a bariatric procedure.
        Surg Obes Relat Dis. 2010; 6: 1-5
        • Kehagias I
        • Zygomalas A
        • Karavias D
        • Karamanakos S
        Sleeve gastrectomy: have we finally found the holy grail of bariatric surgery? A review of the literature.
        Eur Rev Med Pharmacol Sci. 2016; 20 (Dec): 4930-4942
        • Brolin RE
        • Kenler HA
        • Gorman RC
        • et al.
        The dilemma of outcome assessment after operations for morbid obesity.
        Surgery. 1989; 105: 337-346
        • Reinhold RB
        Critical analysis of long-term weight loss following gastric bypass.
        Surg Gynecol Obstet. 1982; 155: 385-394
        • Christou NV
        • Look D
        • Maclean LD
        Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years.
        Ann Surg. 2006; 244: 734-740
        • Lemanu DP
        • Singh PP
        • Rahman H
        • Hill AG
        • Babor R
        • MacCormick AD
        Five-year results after laparoscopic sleeve gastrectomy: a prospective study.
        Surg Obes Relat Dis. 2015; 11: 518-524
        • Lemanu DP
        • Srinivasa S
        • Singh PP
        • et al.
        Single-stage laparoscopic sleeve gastrectomy: safety and efficacy in the super-obese.
        J Surg Res. 2012; 177: 49-54
        • Abd Ellatif ME
        • Abdallah E
        • Askar W
        • et al.
        Long term predictors of success after laparoscopic sleeve gastrectomy.
        Int J Surg. 2014; 12: 504-508
        • Aurora AR
        • Khaitan L
        • Saber AA
        Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients.
        Surg Endosc. 2012; 26: 1509-1515
        • Himpens J
        • Dobbeleir J
        • Peeters G
        Long-term results of laparoscopic sleeve gastrectomy for obesity.
        Ann Surg. 2010; 252: 319-324
        • Schauer PR
        • Bhatt DL
        • Kirwan JP
        • et al.
        for the STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes.
        N Engl J Med. 2017; 376: 641-651
        • Laffin M
        • Chau J
        • Gill RS
        • Birch DW
        • Karmali S
        Sleeve gastrectomy and gastroesophageal reflux disease.
        J Obes. 2013; 2013741097
        • Melissas J
        • Braghetto I
        • Molina JC
        • et al.
        Gastroesophageal reflux disease and sleeve gastrectomy.
        Obes Surg. 2015; 25: 2430-2435
        • Genco A
        • Soricelli E
        • Casella G
        • et al.
        Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication.
        Surg Obes Relat Dis. 2017; 13: 568-574
        • Obeid NR
        • Malick W
        • Concors SJ
        • Fielding GA
        • Kurian MS
        • Ren-Fielding CJ
        Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data.
        Surg Obes Relat Dis. 2016; 12: 11-20
        • Higa K
        • Ho T
        • Tercero F
        • Yunus T
        • Boone KB
        Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up.
        Surg Obes Relat Dis. 2011; 7: 516-525
        • Shoar S
        • Saber AA
        Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies.
        Surg Obes Relat Dis. 2017; 13: 170-180
        • Peterli R
        • Borbély Y
        • Kern B
        • et al.
        Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass.
        Ann Surg. 2013; 258: 690-694
        • Helmiö M
        • Victorzon M
        • Ovaska J
        • et al.
        Comparison of short-term outcome of laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: A prospective randomized controlled multicenter SLEEVEPASS study with 6-month follow-up.
        Scand J Surg. 2014; 103: 175-181