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Obesity Surgery

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01-12-2017 | Original Contributions

Metabolic Effects of Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication: an 18-Month Prospective, Observational, Open-Label Study

Authors: Marek Bužga, Zdeněk Švagera, Hana Tomášková, Karel Hauptman, Pavol Holéczy

Published in: Obesity Surgery | Issue 12/2017

Abstract

Background

Laparoscopic greater curvature plication (LGCP) is an innovative restrictive technique designed to reduce gastric volume by plication at the region of greater curvature. The long-term efficacy, safety, and the metabolic effects of this procedure are the subject of this study.

Methods

One hundred twenty-seven patients were enrolled; 84 underwent laparoscopic sleeve gastrectomy (LSG) and 43, LGCP. LSG and LGCP were then compared during long-term follow-ups in terms of glycemic control, hormone and lipid secretion, and changes in body composition. Measured parameters included serum glucose, triglycerides, high- and low-density lipoprotein cholesterol, testosterone, estradiol, leptin, adiponectin, ghrelin, fatmass, and lean body mass.

Results

Significant weight-loss and a reduced body composition resulted from either procedure vs. baseline (i.e., pre-surgery), with levels of fasting glucose and glycated hemoglobin also showing statistically significant reductions (at 3 and 18 months for either surgery). Intergroup comparisons for glycemic parameters yielded no statistically significant differences. However, a dramatic reduction in ghrelin was detected following LSG, falling from pre-surgery levels of 140.7 to 69.6 ng/L by 6 months (P < 0.001). Subsequently, ghrelin levels increased, reaching 107.8 ng/L by month 12. Conversely, after LGCP, a statistically significant increase in ghrelin was seen, rising from 130.0 ng/L before surgery to 169.0 ng/L by month 12, followed by a slow decline.

Conclusions

Good metabolic outcomes were obtained following LGCP, which might be mediated via altered glucose metabolism and GI hormones. Nevertheless, this method is less effective than LSG, possibly due to its preservation of the entire stomach, including secretory regions.

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Title: Metabolic Effects of Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication: an 18-Month Prospective, Observational, Open-Label Study
Authors: Marek Bužga
Zdeněk Švagera
Hana Tomášková
Karel Hauptman
Pavol Holéczy
Publication date: 01-12-2017
Publisher: Springer US
Published in: Obesity Surgery / Issue 12/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-2779-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Metabolic Effects of Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication: an 18-Month Prospective, Observational, Open-Label Study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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