Objectives: To evaluate short-term outcome of laparoscopic sleeve
gastrectomy (LSG) in terms of changes of body weight (BW), insulin
resistance (IR) and plasma ghrelin levels in non-diabetic obese patients.
Patients & Methods: The study included 33 patients with body mass
index (BMI)>30 kg/m2, normo-glycemia and no associated comorbidities.
All patients underwent determination of BW and BMI and
estimation of fasting blood glucose (FBG), plasma insulin (FPI) and
plasma ghrelin level and calculation of Homeostasis Model Assessment
of Insulin Resistance (HOMA-IR) preoperatively and at 3 and 6
postoperative (PO) months. All patients underwent LSG and collected
surgical data included operative time, time till l st oral intake, duration of
PO hospital stay and frequency and type of complications.
Results: All surgeries passed smoothly without intraoperative
complications or conversion to open procedure within a mean operative
time of 150.8±25 minutes. Mean duration till is' oral intake and PO
hospital stay was 2.6±0.5 and 5.1±1.5 days, respectively. All patients
showed progressive BW loss with significantly lower weight at 3- and 6-
m PO compared to preoperative BW. Percentage of excess weight loss
(%EWL) at 6-m PO was significantly higher compared to 3-m PO °/oEWL. All patients showed steady progressive significant decrease of
their FBG, FPI and plasma ghrelin levels with significant reduction of
HOMA-IR index. Percentage of EWL showed a positive significant
correlation with the percentage of decrease of HOMA-IR at 3-m PO, and
with the percentage of decrease of plasma ghrelin level at 6-m PO.
Conclusion: LSG is feasible and easy to perform with acceptable surgical
outcome. LSG induced progressive significant EWL through a
combination of improved insulin sensitivity and utilization of glucose
during the early PO phase and reduction of plasma ghrelin concentration
with subsequent appetite suppression and decreased food intake during
the late PO phase. |
