Marcos Berry, MD, Lionel Urrutia, MD, José Quezada, MD. Clinica Las Condes
BACKGROUND: Approximately 33% of adolescents in western countries are overweight and obese, and 80 % of them will become adult obese with associated severe co-morbidities. Medical and behavioral intervention remains largely ineffective in this group. We report our experience with bariatric surgery in adolescents at a high volume center in Chile over the last 12 years and their weight loss at 1 year.
METHODS: From 2002 to 2015, 114 adolescents between 13-19 years old underwent bariatric surgery at Clinica Las Condes, a large private medical center in Chile. All of them were assessed by a multidisciplinary team and discussed in a Committee. At the beginning patients only underwent laparoscopic gastric banding (LGB) until 2012, but over the last 10 years, sleeve gastrectomy (LSG) and Roux en Y Gastric bypass (RYGB) were added.
RESULTS: Over this period the number of patients for each surgery were: 40 LGB, 67 LSG and 7 patients had a RYGB. The average age and BMI were 17 (range 13-19) and 36,7 (range 30 – 51) for all three groups, 17 and 37 for LGB, 17 and 35,7 for LSG and for RYGB 18 and 44. All of them had 3 or more comorbidities and the majority resolved after surgery. Major complications included 2 cases of slippage (5%) in the LGB that required removal. No complications in the LSG and 1 micronutrient deficiency (14%) in the RYGB group. No mortality. Mean excess weight loss at 1 year F/U was 54% for LGB, 85% for the LSG group and 72 % for the RYGB.
CONCLUSIONS: Laparoscopic bariatric surgery is safe in adolescents. In adequately selected patients and with strict multidisciplinary team follow up, bariatric surgery is an effective tool to treat obesity in the adolescent. Of the 3 most common bariatric procedures, the LSG and RYGB appear to be more effective in terms of weight loss and safety over the LGB, which is no longer performed at our institution.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80097
Program Number: P530
Presentation Session: Poster (Non CME)
Presentation Type: Poster