Background:
Global Obesity and metabolic diseases ‘s rising tides have affected significantly the shores of the Arabian Gulf and Oman. Obesity is seen in around 40% of females and 25% of males . The Metabolic syndrome prevails in around 25%. Bariatric services at the Royal Hospital, the biggest referral center in the country, started in 2012.
Objective:
To analyse the role of surgery in managing the disease and to emphasise the aspects of our practice that are unique to the setting of Oman.
Methods:
Descriptive retrospective study from a prospective data base of all Bariatric procedures done at the Royal Hospital between 2012 and end December 2016. Statistical analysis was done using SPSS16
Results:
237 cases of Sleeve Gastrectomy were done. 8 of these also had a Duodeno-jejunal bypass for Diabetes.
The average pre-op weight of 130kg and BMI of 47 came at 2 years follow up, to 82 kg and 30 respectively. Pre-op endoscopy was done in 223 (94% ). The incidence of H pylori in these was 92%. Simultaneous procedures were added in 62% including 24 (10%) Cholecystectomies and hiatal repairs 86(36% ).
There were no mortalities, no conversions, no anastomotic leaks, and no stenoses requiring intervention.
Diabetes was in 35% of the group for whom resolution was seen in 85% .
The unique challenges of setting the new service, including the infrastructure, peri-operative care, and follow up are discussed in comparison to other established programs.
Conclusions:
Obesity and its complications in the region, has become a demanding national health priority .
Unique indicators have been set in our protocols including pre-op endoscopy, allowance for simultaneous procedures and specific choice of metabolic techniques.
The results till date offer an encouraging trend with positive early results in both weight loss and improvement of the metabolic syndrome.