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    Comparison of early postoperative outcomes of omentopexy and clips along the staple line during laparoscopic sleeve gastrectomy: a randomized study
    (Springer, 2024) Demirpolat, Muhammed Taha; İslam, Mehmet Muzaffer; Bacaksız, Mehmet Erman; Ertekin, Süleyman Çağlar; Şişik, Abdullah
    Background We aimed to compare the omentopexy and clipping reinforcement methods performed along the staple line during laparoscopic sleeve gastrectomy (LSG) in terms of the effectiveness on postoperative bleeding. Methods In this prospective randomized controlled study, patients were divided into two groups: clips group (CG) and omentopexy group (OG). The groups were compared in terms of postoperative bleeding, duration of surgery, length of hospital stay, hospital readmissions in the postoperative first 30-days. Results A total of 148 patients were included in the study. Postoperative bleeding was observed in 11 patients (14.9%) of CG and 2 patients (2.7%) of the OG, and the difference between the groups was found to be significant (p = 0.009). Similarly, the number of patients with bleeding that did not require intervention was 9 (12.2%) in CG and 2 (2.7%) in OG, and the difference between the groups was also significant (p = 0.028). The duration of surgery in the CG was 30 (27 to 36) minutes, whereas in the OG, it was 43 (39 to 45) minutes, with a significant difference noted (p < 0.001). Additionally, the rate of patients readmitted to the hospital within the first 30 days was 16 (21.6%) in the CG and 7 (9.5%) in the OG, with a significant difference observed (p = 0.041). Conclusion In terms of bleeding requiring intervention, there was no difference between omentopexy and clipping techniques. In addition, omentopexy showed more satisfactory results than clipping in terms of non-interventional bleeding, but its clinical significance is unclear.
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    Comparison of mid- and long-term outcomes of antrum-resecting versus antrum-preserving laparoscopic sleeve gastrectomy
    (Springer, 2025) Demirpolat, Muhammed Taha; İslam, Mehmet Muzaffer; Bacaksız, Mehmet Erman; Şişik, Abdullah; Kermansaravi, Mohammad
    BackgroundThe aim of this study is to compare the mid- and long-term results after laparoscopic sleeve gastrectomy (LSG) according to the distance of the first staple from the pylorus.MethodsThis study is a retrospective analysis of prospectively collected data of patients who underwent LSG. While the distance of the first staple from the pylorus was 2-3 cm in group A, the distance of the first staple to the pylorus was 5-6 cm in group B. Laboratory parameters, comorbidity resolution, anthropometric measurements, and complications were documented at the end of the first, third, and fifth postoperative years.ResultsOf the total 376 patients, 127 were excluded for various reasons, 102 patients were lost to follow-up, and 147 patients were included in the final analysis. Upon examining the follow-up data at the 1st, 3rd, and 5th years, a statistically significant difference was observed between the groups in terms of total weight loss (TWL%), excess body mass index loss (EBMIL%), and recurrent weight gain (RWG)%, with group A showing an advantage. The majority of the patients requiring conversional metabolic and bariatric surgery (MBS) were in group B, and the difference was significant (p = 0.017).ConclusionThe distance of the first staple from the pylorus may significantly influence the outcomes related to RWG%, TWL%, and type 2 diabetes mellitus (T2DM) resolution in the medium-long-term. Furthermore, additional research is needed to determine the optimal positioning for enhanced patient results.
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    Efficacy of ursodeoxycholic acid in reducing the necessity of cholecystectomy due to pre-existing and subsequently formed gallstones in patients who underwent laparoscopic sleeve gastrectomy
    (BMC, 2025) Demirpolat, Muhammed Taha; Çelikkaya, Muhammet Oğuz; Ertekin, Süleyman Çağlar; Başak, Fatih; Şişik, Abdullah
    BackgroundIn this study, we aimed to investigate whether ursodeoxycholic acid (UDCA) would reduce the necessity of cholecystectomy in patients diagnosed with asymptomatic gallstones after laparoscopic sleeve gastrectomy (LSG) and in patients diagnosed with asymptomatic gallstones before LSG.MethodsBetween July 2020 and November 2022, at least 2-year follow-ups of patients who underwent LSG for obesity were retrospectively analyzed. Patients with pre-existing asymptomatic gallstones during preoperative evaluation, those with UDCA treatment (group 1), and observation group (group 2). Patients with newly formed gallstones in postoperative outpatient clinic follow-up, those with UDCA treatment (group A), and those without UDCA treatment (group B).ResultsA total of 425 patients included. At the end of the first year, patients who had newly formed gallstones after LSG had a higher total weight loss percentages (TWL%) (39.8 +/- 6.1) compared to those who did not develop gallstones (37.9 +/- 7.4), which were statistically significant (p = 0.004). Among patients who developed gallstones postoperatively, UDCA treatment was associated with a significantly lower cholecystectomy rate in patients with newly formed gallstones postoperatively (p = 0.025), while no significant difference was shown in patients with preoperative gallstones (p = 0.631).ConclusionUDCA is a promising option for reducing the need for cholecystectomy in patients with post-LSG gallstones, but it appears ineffective for pre-existing gallstones.