Abstract

Laparoscopic sleeve gastrectomy was the most common procedure performed worldwide. It was feasible and associated with fewer complications and metabolic deficiencies compared than other procedures. Inadequate weight loss (IWL) was a critical issue of this procedure and it could depend on technical fault or on preoperative patient factors. The aim of this study was to identify predictive factors of inadequate weight loss investigating on preoperative psychological and dietary behaviour.
Method: A retrospective analysis of patients undergoing sleeve gastrectomy was acquired. Patients with inadequate weight loss (excess weight loss (EWL) <50% at 1 years after procedure) and patients with EWL>50% were compared. Bivariate analysis and multivariate model was performed in order to study preoperative factors focused on psychological (binge eating disorder (BED) and grazing) and dietary (compliance to preoperative diet) behaviour.
Result: 20/85 (23.5%) patients were included in IWL group. In bivariate analysis, predictive factors for IWL were diabetes (p=0.034), insulin-treatment (p=0.037) and patient misbehaviour to preoperative diet (p=0.042). In multivariate model including BMI, BED, grazing and compliance to preoperative diet, misbehaviour to preoperative diet was the predictive factor for IWL (p=0.046).
Conclusion: Patient misbehaviour to preoperative diet was a predictive factor for IWL. Preoperative patients could be based on compliance to preoperative diet.