Study of the Effect of Laparoscopic Gastric Plication On Ghrelin Hormone in Morbidly Obese Patients

Tamer N Abdelbaki, MD, MRCS, Msc, Wael N Abdelsalam, MD, Khaled M Katri, MD, Mohamed Sharaan, MD, Mohamed K El Saidy, MD, Tamer M Mohamed, MBBCH, Elsaid Elkayal, MD. University of Alexandria Faculty of Medicine.

The prevalence of obesity continues to rise worldwide at an alarming rate. This trend was met with an evolution of new bariatric procedures to address the needs of obese patients. Gastric plication is among the new procedures that can effectively manage obesity. Ghrelin is a hormone that is secreted from the gastric lining cells, it increases before meals and decrease after meals. Restrictive bariatric surgery has been proven to affect Ghrelin levels. We here in study the effect of laparoscopic gastric plication on Ghrelin hormone level.

After approval of Alexandria University Hospitals ethical committee, we prospectively studied 20 consecutive patients undergoing laparoscopic gastric plication for the management of obesity from February 2012 to September 2012. Follow up was done at 6 and 12 months. Patient demographics, preoperative and post operative fasting Ghrelin levels were analyzed.

Twenty patients underwent laparoscopic gastric plication including 17 females (85%)  and 3 males (15%). The mean age was 27.70±7.54 years (range 20-50 years) and the mean BMI was 41.33±4.76 (range 35.2-52.1). On follow up patients had a mean %EWL (percentage excess weight loss) of 15.75 ± 4.91 and 22.45 ± 4.697,  at 6 and 12 months respectively. Preoperative Ghrelin levels ranged between 258.3 – 993.0 pg/mL, with a mean of 675.48 ± 187.27 pg/ml. Postoperatively, the mean Ghrelin levels were 554.6 ± 206.57 pg/ml (range 114.3 – 916.7 pg/ml) and 487.38 ± 145.14 pg/ml (range 129.1 – 770.0 pg/ml), at 3 and 6 months respectively. The difference between preoperative and postoperative Ghrelin level was statistically significant (p< 0.001).

Ghrelin hormones level changes significantly after laparoscopic gastric plication for treatment of morbid obesity.

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