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Ultrasound Evaluation of Visceral and Subcutaneous Fat Reduction in Morbidly Obese Subjects Undergoing Laparoscopic Gastric Banding, Sleeve Gastrectomy, and Roux-en-Y Gastric Bypass: A Prospective Comparison Study

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Abstract

Background

Visceral fat (VF) plays a major role in the development of metabolic syndrome associated with obesity. The aim of our study is to compare VF and subcutaneous fat (SCF) reduction measured by ultrasonography (US) after laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-En-Y gastric bypass (LRYGB).

Methods

Thirty-nine morbidly obese patients were prospectively evaluated by US before surgery and 3, 6, and 12 months following surgery to determine VF and SCF thickness.

Results

Three statistically comparable groups of morbidly obese patients underwent LRYGB (n = 13), LSG (n = 15), and LAGB (n = 11). The three groups did not differ in initial age, gender, body mass index (BMI), VF, or SCF. Final excess weight loss (EWL%) was highest after LSG and LRYGB followed by LAGB (81 ± 5.8 vs. 69.5 ± 4.5 vs. 43.4 ± 5.2, p < 0.001). LSG and LRYGB were significantly more efficient in VF reduction (ΔVF) compared with LAGB (7.1 ± 0.5 vs. 5.6 ± 0.6 vs. 3.6 ± 0.8, p = 0.004). SCF reduction (ΔSCF) was also highest after LSG followed by LRYGB and LAGB (3 ± 0.2 vs. 2.2 ± 0.4 vs. 1.9 ± 0.4, p = 0.08). The change in fat distribution, determined as Δ(VF/SCF), showed a preferential VF reduction in the LSG and LRYGB patients compared with patients that underwent LAGB (0.59 ± 0.1 vs. 0.52 ± 0.2 vs. 0.19 ± 0.2, p = 0.42). In a subgroup analysis comparing only LSG to LRYGB, no statistically significant difference was seen in EWL%, ΔVF, ΔSCF, or in fat distribution Δ(VF/SCF).

Conclusion

LSG and LRYGB show better preferential and overall VF reduction than LAGB. US may serve as a simple tool of evaluating postoperative fat distribution.

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Abbreviations

US:

Ultrasonography

VF:

Visceral fat

SCF:

Subcutaneous fat

LAGB:

Laparoscopic adjustable gastric banding

LSG:

Laparoscopic sleeve gastrectomy

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

BMI:

Body mass index

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Conflicts of Interest

All contributing authors declare that they have no conflicts of interest to report.

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, P.O.B. 24035, 91240, Jerusalem, Israel

    Ido Mizrahi, Nahum Beglaibter, Haggi Mazeh, Muhammad Ghanem, Katya Chapchay, Ahmed Eid & Ronit Grinbaum

  2. Department of Radiology, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel

    Natalia Simanovsky & Natali Lioubashevsky

Authors
  1. Ido Mizrahi
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  2. Nahum Beglaibter
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  4. Natali Lioubashevsky
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  5. Haggi Mazeh
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  6. Muhammad Ghanem
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  7. Katya Chapchay
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  8. Ahmed Eid
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  9. Ronit Grinbaum
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Correspondence to Ido Mizrahi.

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Mizrahi, I., Beglaibter, N., Simanovsky, N. et al. Ultrasound Evaluation of Visceral and Subcutaneous Fat Reduction in Morbidly Obese Subjects Undergoing Laparoscopic Gastric Banding, Sleeve Gastrectomy, and Roux-en-Y Gastric Bypass: A Prospective Comparison Study. OBES SURG 25, 959–966 (2015). https://doi.org/10.1007/s11695-014-1495-4

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  • DOI: https://doi.org/10.1007/s11695-014-1495-4

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