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Ghrelin Level and Weight Loss After Laparoscopic Sleeve Gastrectomy and Gastric Mini-Bypass for Prader–Willi Syndrome in Chinese

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Abstract

Prader–Willi syndrome (PWS) is a chromosomal disorder characterized by the presence of hyperghrelinemia, hyperphagia, and obesity. The optimal treatment for PWS patient remains controversial. Here, we present our experience of treating PWS with laparoscopic mini-gastric bypass (LMGBP) and laparoscopic sleeve gastrectomy (LSG). Three patients with genetic diagnosis of PWS and body mass index (BMI) greater than 40 kg/m2 were referred for bariatric surgery. All of them had completed 2-year postoperative follow-up. Body weight, BMI, and ghrelin levels were recorded before and after surgery. They were two females and one male. Their age ranged from 15 to 23 years old, and the mean BMI was 46.7 kg/m2 (range 44–50). Two patients underwent LSG and one patient underwent LMGBP. After a median follow-up of 33 months (range 24–36 months), mean weight loss and percentage of excessive weight loss at 2 years were 32.5 kg (24.9–38.3 kg) and 63.2 % (range 50.5–86.2 %), respectively. The mean fasting active ghrelin level decreased from 1,134.2 pg/ml preoperatively to 519.8 pg/ml 1 year after surgery. No major complication was observed. Iron deficiency anemia was observed in the patient who underwent LMGBP. Significant reduction of body weight and level of serum ghrelin can be achieved with minimal morbidity by LSG or LMGBP in patients with PWS.

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References

  1. Gunay-Aygun M, Schwartz S, Heeger S, et al. The changing purpose of Prader-Willi syndrome clinical diagnostic criteria and proposed revised criteria. Pediatrics. 2001;108(5):E92.

    Article  PubMed  CAS  Google Scholar 

  2. Lindgren AC, Barkeling B, Hägg A, et al. Eating behavior in Prader-Willi syndrome, normal weight, and obese control groups. J Pediatr. 2000;137(1):50–V.

    Article  PubMed  CAS  Google Scholar 

  3. Vogels A, Van Den Ende J, Keymolen K, et al. Minimum prevalence, birth incidence and cause of death for Prader-Willi syndrome in Flanders. Eur J Hum Genet. 2004;12:238–40.

    Article  PubMed  CAS  Google Scholar 

  4. Greenswag LR. Adults with Prader-Willi syndrome: a survey of 232 cases. Dev Med Child Neurol. 1987;29(2):145–52.

    Article  PubMed  CAS  Google Scholar 

  5. Crinò A, Di Giorgio G, De Peppo F, et al. Bioenterics intragastric balloon may represent an alternative and effective treatment for body weight control in Prader-Willi syndrome. Obes Surg. 2009;19(5):674–5.

    Article  PubMed  Google Scholar 

  6. Till H, Bluher S, Hirsch W, et al. Efficacy of laparoscopic sleeve gastrectomy as a stand-alone technique for children with morbid obesity. Obesity Surgery. 2008;18(8):1047–98.

    Article  PubMed  CAS  Google Scholar 

  7. de Almeida MQ, Cercato C, Rascovski A, et al. Results of biliopancreatic diversion in two patients with Prader-Willi syndrome. Obes Surg. 2005;15(6):901–4.

    Article  PubMed  Google Scholar 

  8. Papavramidis ST, Kotidis EV, Gamvros O. Prader-Willi syndrome-associated obesity treated by biliopancreatic diversion with duodenal switch. Case report and literature review. J Pediatr Surg. 2006;41(6):1153–8.

    Article  PubMed  Google Scholar 

  9. Holsen LM, Zarcone JR, Brooks WM, et al. Neural mechanisms underlying hyperphagia in Prader-Willi syndrome. Obesity. 2006;14(6):1028–37.

    Article  PubMed  Google Scholar 

  10. Dousei T, Miyata M, Izukura M, et al. Long-term follow-up of gastroplasty in a patient with Prader-Willi syndrome. Obes Surg. 1992;2(2):189–93.

    Article  PubMed  Google Scholar 

  11. Scheimann AO, Butler MG, Gourash L, et al. Critical analysis of bariatric procedures in Prader-Willi syndrome. J Pediatr Gastroenterol Nutr. 2008;46(1):80–3.

    Article  PubMed  CAS  Google Scholar 

  12. Randolph JG, Weintraub WH, Rigg A. Jejunoileal bypass for morbid obesity in adolescents. J Pediatr Surg. 1974;9:341.

    Article  PubMed  CAS  Google Scholar 

  13. Kobayashi J, Kodarna M, Yamazaki K, et al. Gastric bypass in a Japanese man with Prader-Willi syndrome and morbid obesity. Obes Surg. 2003;13(5):803–5.

    Article  PubMed  Google Scholar 

  14. Anderson AE, Soper RT, Scott DH. Gastric bypass for morbid obesity in children and adolescents. J Pediatr Surg. 1980;15:876–81.

    Article  PubMed  CAS  Google Scholar 

  15. Mui WLM, Ng EKW, Tsung BYS, et al. Laparoscopic sleeve gastrectomy in ethic obese Chinese. Obes Surg. 2008;18:1571–4.

    Article  PubMed  Google Scholar 

  16. Holland AJ, Treasure J, Coskeran P, et al. Measurement of excessive appetite and metabolic changes in Prader-Willi syndrome. Int J Obes. 1993;17:526–32.

    Google Scholar 

  17. Butler MG, Bittel DC, Talebizadeh Z. Plasma peptide YY and ghrelin levels in infants and children with Prader-Willi syndrome. J Pediatr Endocrinol Metab. 2004;17:1177–84.

    Article  PubMed  CAS  Google Scholar 

  18. Kotidis EV, Koliakos GG, Baltzopoulos VG, et al. Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment—a prospective study. Obes Surg. 2006;16(11):1425–32.

    Article  PubMed  Google Scholar 

  19. Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med. 2002;346(21):1623–30. 23.

    Article  PubMed  Google Scholar 

  20. Marinari GM, Camerini G, Novelli GB, et al. Outcome of biliopancreatic diversion in subjects with Prader-Willi syndrome. Obes Surg. 2001;11:491–5.

    Article  PubMed  CAS  Google Scholar 

  21. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.

    Article  PubMed  Google Scholar 

  22. Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242(1):20–8.

    Article  PubMed  Google Scholar 

  23. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.

    Article  PubMed  Google Scholar 

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The authors do not have any conflict of interest to disclose.

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Authors and Affiliations

  1. Division of Upper GI Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China

    Anthony K. W. Fong, Simon K. H. Wong, Candice C. H. Lam & Enders K. W. Ng

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  1. Anthony K. W. Fong
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  2. Simon K. H. Wong
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  3. Candice C. H. Lam
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  4. Enders K. W. Ng
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Correspondence to Enders K. W. Ng.

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Fong, A.K.W., Wong, S.K.H., Lam, C.C.H. et al. Ghrelin Level and Weight Loss After Laparoscopic Sleeve Gastrectomy and Gastric Mini-Bypass for Prader–Willi Syndrome in Chinese. OBES SURG 22, 1742–1745 (2012). https://doi.org/10.1007/s11695-012-0725-x

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