Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels.
BACKGROUND
Different changes of plasma ghrelin levels have been reported following gastric banding, Roux-en-Y gastric bypass, and biliopancreatic diversion.


METHODS
This prospective study compares plasma ghrelin levels and weight loss following laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) in 20 patients.


RESULTS
Patients who underwent LSG (n=10) showed a significant decrease of plasma ghrelin at day 1 compared to preoperative values (35.8 +/- 12.3 fmol/ml vs 109.6 +/- 32.6 fmol/ml, P=0.005). Plasma ghrelin remained low and stable at 1 and 6 months postoperatively. In contrast, no change of plasma ghrelin at day 1 (71.8 +/- 35.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.441) was found in patients after LAGB (n=10). Increased plasma ghrelin levels compared with the preoperative levels at 1 (101.9 +/- 30.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.028) and 6 months (104.9 +/- 51.1 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.012) after surgery were observed. Mean excess weight loss was higher in the LSG group at 1 (30 +/- 13% vs 17 +/- 7%, P=0.005) and 6 months (61 +/- 16% vs 29 +/- 11%, P=0.001) compared with the LAGB group.


CONCLUSIONS
As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.
Langer
F B
FB
Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria.
Reza Hoda
M A
MA
Bohdjalian
A
A
Felberbauer
F X
FX
Zacherl
J
J
Wenzl
E
E
Schindler
K
K
Luger
A
A
Ludvik
B
B
Prager
G
G
D000328:Adult; D005260:Female; D005743:Gastrectomy; D015391:Gastroplasty; D054439:Ghrelin; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D036361:Peptide Hormones / Q000097:blood*; D011446:Prospective Studies; D015431:Weight Loss
D054439:Ghrelin; D036361:Peptide Hormones