Protein Intake Compliance of Morbidly Obese Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass and its Effect on Weight Loss, Leptin and Albumin.

Bariatric Center, Saint Francis Hospital and Medical Center, Hartford, CT; Pediatrics and Surgery, Saint Francis Hospital, Hartford, CT

Low daily protein intake (DPI) after laparoscopic Roux-en-Y Gastric Bypass (LRYGB) has been reported. This presentation discussed the DPI measurements after the LRYGB procedure and its effect on weight loss, leptin and albumin levels. Two hundred thirty LRYGB patients were taken into consideration for this study. There were 200 females with a mean age of 41 years old and an average BMI of 47 kg/m2. There was an apparent correlation of DPI with the lowest BMI after a year. However, in patients with a higher DPI after a year, there was a large leptin level drop and a greater BMI drop, determining no increase in serum albumin. As a result, higher DPI benefits weight loss and nutritional status a year after LRYGB surgery.

Editorial: The take home message is that the higher the protein intake the better the weight loss in gastric bypass patients. I am not aware of a similar study for Duodenal Switch patients but I would venture to guess that the parallel also applies to the Duodenal Switch patients.
Ara Keshishian, MD

Laparoscopic Sleeve Gastrectomy in Adolescents, Results in 51 Patients

Pontificia Universidad Catolica de Chile, Santiago, CHILE

It’s an unfortunate fact that such a majority of today’s adolescents develop obesity and develop multitude of medical and psychosocial problems. This particular research was done to investigate the observations and execution of the Laparoscopic sleeve gastrectomy (LSG). 50 patients were analyzed and studied from the beginning of 2006 till late 2009 examining % excess weight loss (%EWL) and the teenagers’ general happiness. Many of the cases werefemales averaging 18 years old with an approximated BMI of 36. Of these patients many were diagnosed with comorbidities. The LSG has proven to be a dependable and accomplishedsurgery resulting in 95% weight loss after a year and a half leaving 76% of patients with resolved co morbidities. Most importantly, this allowed the adolescents to have a better outlook on life and more self-esteem for themselves. The sleeve gastrectomy is proven to be a safe approach with favorable weight loss data along with an effective resolution of obesity.

Editorial: Note that the outcome data is only for 1.5 year. As with all weight loss surgical procedures it is very important to look at what happens to the patients long term over 5-10 year period and not over the short term. As one of the issues that was noted in a number of presentations, there is still no uniform baseline reporting in place. Different procedures all claim to be successful, yet when you look at the fine print some had a follow up of months and other years.
Ara Keshishian, MD

Interim Outcomes Report of Adjustable Gastric Banding In 402 Adolescents at a Single Center

Jacksonville Surgical Associates, Jacksonville, FL

Adolescent obesity is on the rise and is one of the major problems teens face today. The purpose of this study was to analyze the safety and success rate ofthe Lap band in America’s youth. Four hundred patients aged 10 to 20 years old were used in this case because they had the gastric band surgery performed. The study recorded complications, weight loss and demographics. The average BMI (3:1 ratio for women to men), was 43. The study also showed that there was a general reduction in associated comorbidities. In summary, adolescent adjustable gastric banding is effective at minimizing weight and keeping it off with a very low rate of drawbacks in the future. This information may later be used to initiate a weight loss program to reduce adolescent obesity.