Endocrine Abstracts

Introduction: Bariatric surgery is the treatment which has shown the most important effectiveness in terms of weight reduction, improvement of co morbidities, quality of life and mortality on the long term, in the case of massive obesity and obesity associated with co–morbidities. The purposes of our study: clarify the place of bariatric surgery in the treatment of obesity, define the criteria of selections of patients.

Material and Methods: It’s a retrospective study of ten patients who underwent bariatric surgery over a period of 1 year, from 1 April 2016 to 31 March 2017 at the service of general surgery in the Avicenna military hospital of Marrakech.

Results: The average age of patients was 33.7 years, a net predominance of women with 90% and a sex ratio of 0, 11. The mean BMI of our patients was 45.15 kg/m² with extremes ranging from 40.67 to 54 kg/m². Our patients followed a standard care pathway, with a multidisciplinary assessment including a consultation in endocrinology, in psychiatry and in gastroenterology. Pre–operative assessment diagnosed comorbidities related to obesity, in our study the results were: dyslipidemia 50% cases, Obstructive Sleep Apnea Syndrome 40% cases, type 2 diabetes 30% cases, NASH 60% cases, ischemic heart disease 10% cases, hypertension 10% cases. All patients received a coelioscopic approach. The main surgery technique was the sleeve gastrectomy. The surgical time averaged 2 h17 minutes with extremes ranging from 1 h 40 to 2 h 50 minutes. The postoperative period was uneventful for 9 patients; one patient has an infectious peritonitis, re–operated J 3 after the sleeve, it evaluated to a multiple organ failure, we deplore the death of the patient at J5. The hospital stay duration averaged 13 days with extremes ranging from 5 to 25 days.

Conclusion: These benefits of bariatric surgery are to compare with the immediate and late complications and the peri–operative mortality risk, hence the interest of an optimal preoperative evaluation, per operative monitoring and postoperative management of complications.