Changes in Obesity-Related Diseases and Biochemical Variables After Laparoscopic Sleeve Gastrectomy

A Two-Year Follow-up Study

Villy Våge; Vetle Aaberge Sande; Gunnar Mellgren; Camilla Laukeland; Jan Behme; John Roger Andersen

Disclosures

BMC Surg. 2014;14(8) 

In This Article

Results

For the 117 patients studied (87 women and 30 men), the mean weight prior to the operation was 135.6 kg ± 23.7 kg (standard deviation (SD)), mean BMI 46.6 ± 6.0 kg/m2, and mean age 40.3 ± 10.7 years (Table 1).

Complications

Major complications included bleeding (5.1%, n = 6), leak (1.7%, n = 2) and abscess without a visible leak (0.9%, n = 1) (Table 2). One patient had both bleeding and leak. The two patients who had a leak were treated with nil by mouth and a nasojejunal feeding tube for two and five months respectively before it healed. Both leaks were at the cardiac region. Two of the patients with bleeding had relaparoscopy with evacuation of blood (1.7%). There was no conversion of laparoscopic to open surgery and no mortality.

Obesity-Related Diseases

LSG significantly lowered the BMI to 30.3 ± 5.9 kg/m2 and 30.6 ± 5.6 kg/m2 at 12 and 24 months respectively, and resolved obesity-related diseases (Table 3). At two years, the remission-rate for Type 2 Diabetes Mellitus (T2DM) was 80.7%, hypertension 63.9%, hyperlipidemia 75.8%, sleep apnoea 93.0%, musculoskeletal pain 31.4%, snoring 85.4% and urinary leakage 73.3%. Amenorrhea was resolved for all premenopausal female patients with two years data. We lacked two year data for three of our twelve patients with preoperative amenorrhea. The prevalence of gastroesophageal reflux disease (GERD) increased from 12.8% prior to the operation to 27.4% at two years (p = 0.011).

Biochemical Variables

Of the biochemical variables, ferritin was lowered while 25 (OH)-vitamin D, albumin and alanine amino transferase (ALT) improved significantly postoperatively (Table 4). We found a high prevalence of patients with Parathyroid hormone (PTH) above reference-level both preoperatively and postoperatively. Hemoglobin-, folic acid-, cobalamine-, 1, 25-dihydroxyvitamin D (1,25(OH)2D), alkaline phosphatase (ALP), PTH and calcium levels did not change significantly after the procedure but 87% of the patients were taking vitamin and/or mineral supplements 24 months after the operation (Table 5). There was no difference in the vitamin or mineral status when comparing patients using supplements (n = 83) with patients not using supplements (n = 12) (chi-square test and t-test).

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