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Significant Weight Loss and Rapid Resolution of Diabetes and Dyslipidemia During Short-Term Follow-Up After Laparoscopic Sleeve Gastrectomy

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Abstract

Background

Bariatric surgery has been established as the best option of treatment for morbid obesity. Recently, laparoscopic sleeve gastrectomy (SG) has become very popular because of good postoperative weight loss and low morbidity. The aim of this study was to report our single-center experience with SG regarding feasibility, morbidity, and outcome.

Methods

From January 2006 to December 2011, 93 patients (68 female) with a median age of 46 years underwent laparoscopic SG at our department. Thirteen patients had a history of gastric banding with insufficient weight loss or band-related complications. Clinical outcome and laboratory findings were analyzed.

Results

The mean preoperative and postoperative body mass index (BMI) was 44.1 ± 6.9 and 33.4 ± 6.8 kg/m2, respectively (p < 0.001). The mean excessive body weight loss after a median follow-up of 11.9 months was 55.7 % ± 24.9 %. Three bleedings, two staple line leakages, and a deep wound infection required conversion to laparotomy (n = 1), reoperation (n = 4), or endoscopic stent implantation (n = 2). Resolution of diabetes and dyslipidemia was seen in 85 and 50 % of patients, respectively. Blood test results of HbA1c, cholesterols, triglycerides, and leptin showed significant postoperative improvement.

Conclusions

Laparoscopic SG represents a feasible bariatric procedure with good short-term weight loss, low morbidity rate, and efficient resolution of diabetes and dyslipidemia, especially in patients with lower BMI. The significant decrease of leptin necessitates further studies to understand the ambiguous role of leptin in bariatric surgery.

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References

  1. Frezza EE, Wachtel MS. The economic impact of morbid obesity. Surg Endosc. 2009;23(4):677–9.

    Article  PubMed  Google Scholar 

  2. Glatt D, Sorenson T. Metabolic and bariatric surgery for obesity: a review. S D Med Spec . 2011;57–62.

  3. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8(3):267–82.

    Article  PubMed  CAS  Google Scholar 

  4. Regan JP, Inabnet WB, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.

    Article  PubMed  CAS  Google Scholar 

  5. Deitel M, Crosby RD, et al. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18(5):487–96.

    Article  PubMed  Google Scholar 

  6. Brethauer SA, Hammel JP, et al. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5(4):469–75.

    Article  PubMed  Google Scholar 

  7. Gagner M, Deitel M, et al. The Second International Consensus Summit for Sleeve Gastrectomy, March 19–21, 2009. Surg Obes Relat Dis. 2009;5(4):476–85.

    Article  PubMed  Google Scholar 

  8. Lakdawala MA, Bhasker A, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20(1):1–6.

    Article  PubMed  Google Scholar 

  9. Omana JJ, Nguyen SQ, et al. Comparison of comorbidity resolution and improvement between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding. Surg Endosc. 2010;24(10):2513–7.

    Article  PubMed  Google Scholar 

  10. Gumbs AA, Gagner M, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.

    Article  PubMed  Google Scholar 

  11. Akkary E, Duffy A, et al. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18(10):1323–9.

    Article  PubMed  Google Scholar 

  12. Sammour T, Hill AG, et al. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20(3):271–5.

    Article  PubMed  Google Scholar 

  13. Nehoda H, Weiss H, et al. Results and complications after adjustable gastric banding in a series of 250 patients. Am J Surg. 2001;181(1):12–5.

    Article  PubMed  CAS  Google Scholar 

  14. Mittermair RP, Obermüller S, et al. Results and complications after Swedish adjustable gastric banding—10 years experience. Obes Surg. 2009;19(12):1636–41.

    Article  PubMed  Google Scholar 

  15. Lanthaler M, Mittermair R, et al. Laparoscopic gastric re-banding versus laparoscopic gastric bypass as a rescue operation for patients with pouch dilatation. Obes Surg. 2006;16(4):484–7.

    Article  PubMed  CAS  Google Scholar 

  16. Perathoner A, Weiss H, et al. Is a pouch compulsory in Roux-en-Y gastric bypass after failed adjustable gastric banding? Obes Surg. 2008;18(12):1544–50.

    Article  PubMed  CAS  Google Scholar 

  17. Almogy G, Crookes PF, et al. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14(4):492–7.

    Article  PubMed  Google Scholar 

  18. Mognol P, Chosidow D, et al. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15(7):1030–3.

    Article  PubMed  Google Scholar 

  19. Himpens J, Dapri G, et al. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.

    Article  PubMed  Google Scholar 

  20. Abbatini F, Rizzello M, et al. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes. Surg Endosc. 2010;24(5):1005–10.

    Article  PubMed  CAS  Google Scholar 

  21. Lanthaler M, Aigner F, et al. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20:1078–85.

    Article  PubMed  Google Scholar 

  22. Ramalingam G, Anton CK. Our 1-year experience in laparoscopic sleeve gastrectomy. Obes Surg. 2011;21(12):1828–33.

    Article  PubMed  Google Scholar 

  23. Prasad P, Tantia O, et al. An analysis of 1–3-year follow-up results of laparoscopic sleeve gastrectomy: an Indian perspective. Obes Surg. 2012;22(3):507–14.

    Article  PubMed  Google Scholar 

  24. Langer FB, Reza Hoda MA, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15(7):1024–9.

    Article  PubMed  CAS  Google Scholar 

  25. Kotidis EV, Koliakos GG, et al. Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment—a prospective study. Obes Surg. 2006;16(11):1425–32.

    Article  PubMed  Google Scholar 

  26. Frezza EE, Chiriva-Internati M, et al. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today. 2008;38(6):481–3.

    Article  PubMed  CAS  Google Scholar 

  27. Holst JJ. The physiology of glucagon like peptide 1. Physiol Rev. 2007;87:1409–39.

    Article  PubMed  CAS  Google Scholar 

  28. Gutzwiller JP, Goke B, et al. Glucagon like peptide 1: a potent regulator of food intake in humans. Gut. 2008;44:81–6.

    Article  Google Scholar 

  29. Ramon JM, Salvans S, et al. Effect of Roux en Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomized trial. J Gastrointest Surg. 2012;16:1116–22.

    Article  PubMed  Google Scholar 

  30. Michalakis K, Le Roux C. Gut hormones and leptin: impact on energy control and changes after bariatric surgery—what the future holds. Obes Surg. 2012;22:1648–57.

    Article  PubMed  Google Scholar 

  31. Jacobs M, Bisland W, et al. Laparoscopic sleeve gastrectomy: a retrospective review of 1 and 2 years results. Surg Endosc. 2010;24(4):781–5.

    Article  PubMed  Google Scholar 

  32. Menenakos E, Stamou K, et al. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow up of 1 year. Obes Surg. 2010;20(3):276–82.

    Article  PubMed  Google Scholar 

  33. Sanchez-Santos R, Masdevall C, et al. Short and midterm outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg. 2009;19(9):1203–10.

    Article  PubMed  Google Scholar 

  34. Bellanger D, Greenway F. Laparoscopic sleeve gastrectomy, 529 cases without a leak: short term results and technical considerations. Obes Surg. 2011;21(2):146–50.

    Article  PubMed  Google Scholar 

  35. Fischer L, Hildebrandt C, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22:721–31.

    Article  PubMed  Google Scholar 

  36. Chowbey PK, Dhawan K, et al. Laparoscopic sleeve gastrectomy: an Indian experience-surgical technique and early results. Obes Surg. 2010;20(10):1340–7.

    Article  PubMed  CAS  Google Scholar 

  37. Lee WJ, Chen CY, et al. Changes in postprandial gut hormones after metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(6):683–90.

    Article  PubMed  Google Scholar 

  38. Woelnerhanssen B, Peterli R, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux en Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–8.

    Article  PubMed  Google Scholar 

  39. Marantos G, Daskalakis M, et al. Changes in metabolic profile and adipoinsular axis in morbidly obese premenopausal females treated with restrictive bariatric surgery. World J Surg. 2011;35(9):2022–30.

    Article  PubMed  Google Scholar 

  40. Stefater M, Perez-Tilve D, et al. Sleeve gastrectomy induces loss of weight and fat mass in obese rats, but does not affect leptin sensitivity. Gastroenterology. 2010;138(7):2426–36.

    Article  PubMed  CAS  Google Scholar 

  41. Rodriguez A, Becerril S, et al. Short term effects of sleeve gastrectomy and caloric restriction on blood pressure in diet induced obese rats. Obes Surg. 2012;22:1481–90.

    Article  PubMed  Google Scholar 

  42. Gautron L, Elmquist JK, et al. Sixteen years and counting: an update on leptin in energy balance. J Clin Invest. 2011;121:2087–93.

    Article  PubMed  CAS  Google Scholar 

  43. Lopez P, Nicholson S, et al. Development of a sleeve gastrectomy weight loss model in obese Zucker rats. J Surg Res. 2009;157:243–50.

    Article  PubMed  Google Scholar 

  44. Lacy A, Ibarzabal A, et al. Revisional surgery after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(5):351–6.

    Google Scholar 

  45. Iannelli A, Schneck AS, et al. Laparoscopic sleeve gastrectomy as revisional procedure for failed gastric banding and vertical banded gastroplasty. Obes Surg. 2009;19(9):1216–20.

    Article  PubMed  Google Scholar 

  46. Foletto M, Prevedello L, et al. Sleeve gastrectomy as revisional procedure for failed gastric banding or gastroplasty. Surg Obes Relat Dis. 2010;6(2):146–51.

    Google Scholar 

  47. Baker RS, Foote J, et al. The science of stapling and leaks. Obes Surg. 2004;14(10):1290–8.

    Article  PubMed  Google Scholar 

  48. Consten EC, Gagner M, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14(10):1360–6.

    Article  PubMed  Google Scholar 

  49. Himpens J, Dobbeleir J, et al. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.

    Article  PubMed  Google Scholar 

  50. D’Hondt M, Vanneste S, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.

    Article  PubMed  Google Scholar 

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Perathoner, A., Weißenbacher, A., Sucher, R. et al. Significant Weight Loss and Rapid Resolution of Diabetes and Dyslipidemia During Short-Term Follow-Up After Laparoscopic Sleeve Gastrectomy. OBES SURG 23, 1966–1972 (2013). https://doi.org/10.1007/s11695-013-1038-4

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