Skip to main content
Top
Published in: Obesity Surgery 12/2013

01-12-2013 | Original Contributions

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

Authors: A. Perathoner, A. Weißenbacher, R. Sucher, E. Laimer, J. Pratschke, R. Mittermair

Published in: Obesity Surgery | Issue 12/2013

Login to get access

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.
Literature
1.
2.
go back to reference Glatt D, Sorenson T. Metabolic and bariatric surgery for obesity: a review. S D Med Spec . 2011;57–62. Glatt D, Sorenson T. Metabolic and bariatric surgery for obesity: a review. S D Med Spec . 2011;57–62.
3.
4.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
5.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
6.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
7.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
8.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
9.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
10.
11.
go back to reference Akkary E, Duffy A, et al. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18(10):1323–9.PubMedCrossRef Akkary E, Duffy A, et al. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18(10):1323–9.PubMedCrossRef
12.
go back to reference Sammour T, Hill AG, et al. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20(3):271–5.PubMedCrossRef Sammour T, Hill AG, et al. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20(3):271–5.PubMedCrossRef
13.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
14.
go back to reference Mittermair RP, Obermüller S, et al. Results and complications after Swedish adjustable gastric banding—10 years experience. Obes Surg. 2009;19(12):1636–41.PubMedCrossRef Mittermair RP, Obermüller S, et al. Results and complications after Swedish adjustable gastric banding—10 years experience. Obes Surg. 2009;19(12):1636–41.PubMedCrossRef
15.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
16.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
17.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
18.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
19.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
20.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
21.
go back to reference Lanthaler M, Aigner F, et al. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20:1078–85.PubMedCrossRef Lanthaler M, Aigner F, et al. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20:1078–85.PubMedCrossRef
22.
go back to reference Ramalingam G, Anton CK. Our 1-year experience in laparoscopic sleeve gastrectomy. Obes Surg. 2011;21(12):1828–33.PubMedCrossRef Ramalingam G, Anton CK. Our 1-year experience in laparoscopic sleeve gastrectomy. Obes Surg. 2011;21(12):1828–33.PubMedCrossRef
23.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
24.
go back to reference Langer FB, Reza Hoda MA, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15(7):1024–9.PubMedCrossRef Langer FB, Reza Hoda MA, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15(7):1024–9.PubMedCrossRef
25.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
26.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
28.
go back to reference Gutzwiller JP, Goke B, et al. Glucagon like peptide 1: a potent regulator of food intake in humans. Gut. 2008;44:81–6.CrossRef Gutzwiller JP, Goke B, et al. Glucagon like peptide 1: a potent regulator of food intake in humans. Gut. 2008;44:81–6.CrossRef
29.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
30.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
31.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
32.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
33.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
34.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
35.
go back to reference Fischer L, Hildebrandt C, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22:721–31.PubMedCrossRef Fischer L, Hildebrandt C, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22:721–31.PubMedCrossRef
36.
go back to reference Chowbey PK, Dhawan K, et al. Laparoscopic sleeve gastrectomy: an Indian experience-surgical technique and early results. Obes Surg. 2010;20(10):1340–7.PubMedCrossRef Chowbey PK, Dhawan K, et al. Laparoscopic sleeve gastrectomy: an Indian experience-surgical technique and early results. Obes Surg. 2010;20(10):1340–7.PubMedCrossRef
37.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
38.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
39.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
40.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
41.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
42.
go back to reference Gautron L, Elmquist JK, et al. Sixteen years and counting: an update on leptin in energy balance. J Clin Invest. 2011;121:2087–93.PubMedCrossRef Gautron L, Elmquist JK, et al. Sixteen years and counting: an update on leptin in energy balance. J Clin Invest. 2011;121:2087–93.PubMedCrossRef
43.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
44.
go back to reference Lacy A, Ibarzabal A, et al. Revisional surgery after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(5):351–6. Lacy A, Ibarzabal A, et al. Revisional surgery after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(5):351–6.
45.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
46.
go back to reference 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. 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.
47.
48.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
49.
go back to reference Himpens J, Dobbeleir J, et al. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.PubMedCrossRef Himpens J, Dobbeleir J, et al. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.PubMedCrossRef
50.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
Metadata
Title
Significant Weight Loss and Rapid Resolution of Diabetes and Dyslipidemia During Short-Term Follow-Up After Laparoscopic Sleeve Gastrectomy
Authors
A. Perathoner
A. Weißenbacher
R. Sucher
E. Laimer
J. Pratschke
R. Mittermair
Publication date
01-12-2013
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-1038-4

Other articles of this Issue 12/2013

Obesity Surgery 12/2013 Go to the issue