Treatment with sibutramine prior to Roux-en-Y gastric bypass leads to an improvement of metabolic parameters and to a reduction of liver size and operative time.
BACKGROUND
Previous studies have shown that a preoperative weight loss is associated with better long-term outcome, fewer complications, and less time in the operating room in bariatric patients. However, preoperative weight loss is hard to achieve in many patients.


METHODS
We, therefore, conducted a study in which 20 bariatric patients received 15 mg of the weight loss medication sibutramine prior to laparoscopic Roux-en-Y gastric bypass (RYGBP) while patients in the control group did not. It was our interest to find out if these patients had a benefit compared to a control group who did not receive medication.


RESULTS
Whereas patients in the sibutramine group lost 4.8 kg within 6 weeks, patients in the control group gained 7.0 kg. Along with the change in weight, the size of the left liver lobe decreased in the sibutramine-treated patients and increased in the control group. Glutamic pyruvic transaminase as a parameter of liver function improved with reduction of liver size. Finally, time in the operating room was shorter for patients with preoperative weight loss due to sibutramine intake.


CONCLUSIONS
Medical therapy with sibutramine in preparation for bariatric surgery can improve the health status of patients and lead to a reduction of liver size and operating time. It should be considered as an alternative or addition to dietary therapy or gastric balloon treatment in the preparation of patients expecting a RYGBP.
Aberle
Jens
J
Zentrum für Innere Medizin und Zentrum für Operative Medizin, Interdisziplinäres Adipositas Zentrum, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany. aberle@uke.uni-hamburg.de
Freier
Anna
A
Busch
Philipp
P
Mommsen
Nina
N
Beil
Frank U
FU
Dannheim
Viola
V
Mann
Oliver
O
D000328:Adult; D001067:Appetite Depressants / Q000627:therapeutic use*; D003503:Cyclobutanes / Q000627:therapeutic use*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000502:physiology; D008297:Male; D009767:Obesity, Morbid / Q000188:drug therapy* / Q000378:metabolism* / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D015431:Weight Loss / Q000502:physiology*
D001067:Appetite Depressants; D003503:Cyclobutanes; C058254:sibutramine