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Sleeve gastrectomy is a safe technique in patients with BMI45 and effective in terms of weight loss in the short-medium term. In patients with BMI55, a preoperative optimization aimed at reducing morbidity and mortality is necessary, as well as adequately planning the second stage, without which it is clearly insufficient. 55, a preoperative optimization aimed at reducing morbidity and mortality is necessary, as well as adequately planning the second stage, without which it is clearly insufficient. Use of laparoscopic pancreatic