Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Miranda PJ, De Fronzo RA, Califf RM, et al. Metabolic syndrome: definition, pathophysiology, and mechanisms. Am Heart J. 2005;149:33–45.

  2. Gaur A, Rao NP, Sharma S, et al. The effect of laparoscopis sleeve gastrectomy (LSG) on glycemic control in morbidly obese patients. Int J Surg. 2016;28:131–5.

  3. Badaoui R, Chentoufi YA, Hchikat A, et al. Outpatient laparoscopic sleeve gastrectomy: first 100 cases. J Clin Anesth. 2016;34:85–90.

  4. Shah N, Greenberg JA, Leverson G, et al. Weight loss after bariatric surgery: a propensity score analysis. J Surg Res. 2016:449–54.

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

  6. D’Hondt M, Vanneste S, Pottel H, 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;25:2498–504.

  7. Péquignot A, Dhahri A, Verhaeghe P, et al. Efficiency of laparoscopic sleeve gastrectomy on metabolic syndrome disorders: two years results. J Visceral Surg. 2012;149:350–5.

  8. Adamczyk P, Buzga M, Holeczy P, et al. Bone mineral density and body composition after laparoscopic sleeve gastrectomy in men: a short-term longitudinal study. Int J Surg. 2015;23:101–7.

  9. Alexandrou A, Athanasiou A, Michalinos A, et al. Laparoscopic sleeve gastrectomy for morbid obesity: 5-year results. Am J Surg. 2015;209:230–4.

  10. Petreli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22:740–8.

  11. Langer FB, Hoda RMA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.

  12. Gebelli JP, de Gordejuela RAG, Badía AC, et al. Laparoscopic gastric plication: a new surgery for the treatment of morbid obesity. Cir Esp. 2011;89(6):356–61.

  13. Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and complications in a series of 135 patients. Obes Surg. 2011;21:1657–63.

  14. Fried M, Dolezalova K, Buchwald JN, et al. Laparoscopic greater curvature plication (LGCP) for treatment of morbid obesity in a series of 244 patients. Obes Surg. 2012;22:1298–307.

  15. Zerrweck C, Rodríguez JG, Aramburo E, et al. Revisional surgery following laparoscopic gastric plication. Obes Surg. 2017;27:38–43.

  16. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

  17. Vanguri P, Brengman M, Oiticica C, et al. Laparoscopic gastric plication in the morbidly obese adolescent patient. Semin Pediatr Surg. 2014;23:24–30.

  18. Bradnova O, Kyrou I, Hainer V, et al. Laparoscopic greater curvature plication in morbidly obese women with type 2 diabetes: effects on glucose homeostasis, postprandial Triglyceridemia and selected gut hormones. Obes Surg. 2014;24:718–26.

  19. Pok EH, Lee WJ, Ser KH, et al. Laparoscopic sleeve gastrectomy in Asia: long term outcome and revisional surgery. Asian J Surg. 2016;39:21–8.

  20. Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013;9:21–5.

  21. Zachariah SK, Chang PC, Ooi ASE, et al. Laparoscopic sleeve gastrectomy for morbid obesity: 5 years experience from an Asian Center of Excellence. Obes Surg. 2013;23:939–46.

  22. Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007;17:793–8.

  23. Chouillard E, Schoucair N, Alsabah S, et al. Laparoscopic gastric plication (LGP) as an alternative to laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity: a preliminary, short-term, case-control study. Obes Surg. 2016;26:1167–72.

  24. Carey DG, Pliego GJ, Raymond RL, et al. Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass and basal metabolic rate. Obes Surg. 2006;16:469–77.

  25. Nogués X, Goday A, Peña MJ, et al. Bone mass loss after sleeve gastrectomy: a prospective comparative study with gastric bypass. Cir Esp. 2010;88(2):103–9.

  26. Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20:1171–7.

  27. Slater BJ, Bellatorre N, Eisenberg D. Early postoperative outcomes and medication cost savings after laparoscopic sleeve gastrectomy in morbidly obese patients with type 2 diabetes. J Obes. 2011; doi:10.1155/2011/350523.

  28. Zhang F, Strain GW, Lei W, et al. Changes in lipid profiles in morbidly obese patients after laparoscopic sleeve gastrectomy (LSG). Obes Surg. 2011;21:305–9.

  29. Langer FB, Hoda MAR, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.

  30. Ariyasu H, Takaya K, Tagami T. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab. 2001;86:4753–8.

  31. Bužga M, Zavadilová V, Holéczy P, et al. Dietary intake and ghrelin and leptin changes after sleeve gastrectomy. Videosurgery Miniinv. 2014;9(4):554–61.

  32. Leidy HJ, Gardner JK, Frye BR, et al. Circulating ghrelin is sensitive to changes in body weight during a diet and exercise program in normal-weight young women. J Clin Endocrinol Metab. 2004;89:2659–64.

  33. Hansen TK, Dall R, Hosoda H, et al. Weight loss increases circulating levels of ghrelin in human obesity. Clin Endocrinol. 2002;56:203–6.

  34. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365:1597–604.

  35. Hooper LE, Foster-Schubert KE, Weigle DS, et al. Frequent intentional weight loss is associated with higher ghrelin and lower glucose and androgen levels in postmenopausal women. Nutr Res. 2010;30:163–70.

  36. Zigman JM, Bouret SG, Andrews ZB. Obesity impairs the action of the neuroendocrine ghrelin system. Trends Endocrinol Metab. 2016;27(1):54–63.

  37. Mathus-Vliegen EMH, Eichenberger RI. Fasting and meal-suppressed ghrelin levels before and after Intragastric balloons and balloon-induced weight loss. Obes Surg. 2014;24:85–94.

Download references

Author information

Authors and Affiliations

  1. Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic

    Marek Bužga & Karel Hauptman

  2. Institute of Laboratory Diagnostics, University Hospital Ostrava, 17. listopadu 1970/5, Ostrava, Czech Republic

    Zdeněk Švagera

  3. Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic

    Hana Tomášková

  4. Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic

    Pavol Holéczy

Authors
  1. Marek Bužga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zdeněk Švagera
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hana Tomášková
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karel Hauptman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pavol Holéczy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zdeněk Švagera.

Ethics declarations

Ethical Approval

All procedures performed in study were in accordance with the ethical standards of the University hospital and Faculty of Medicine, University of Ostrava, Czech Republic, in accordance with the ethical standards of the Helsinki Declaration of 1975, as revised in 2000.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bužga, M., Švagera, Z., Tomášková, H. et al. Metabolic Effects of Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication: an 18-Month Prospective, Observational, Open-Label Study. OBES SURG 27, 3258–3266 (2017). https://doi.org/10.1007/s11695-017-2779-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-017-2779-2

Keywords

Search

Navigation