Obesity Surgery

, Volume 20, Issue 5, pp 600–609

Effects of Two Variants of Roux-en-Y Gastric Bypass on Metabolism Behaviour: Focus on Plasma Ghrelin Concentrations Over a 2-Year Follow-up

  • Noelia Pérez-Romero
  • Assumpta Serra
  • Maria Luisa Granada
  • Miquel Rull
  • Antonio Alastrué
  • Maruja Navarro-Díaz
  • Ramón Romero
  • Jaime Fernández-Llamazares
Clinical Research



To study the effects of two variants of Roux-en-Y gastric bypass (RYGBP) on plasma ghrelin concentrations according to different exposure of gastric fundus to the nutrient pathway.


A prospective longitudinal 2-year follow-up study was conducted. Ninety-six morbidly obese (MO) patients (age range: 41.6 ± 9.6 years, body mass index: 53 ± 9.5 kg/m2) were assigned to two bariatric surgical (BS) procedures: one that preserves food contact with gastric fundus (ringed RYGBP, n = 50) and the other that avoids it (modified RYGBP, n = 46). Different anthropometric and biochemical parameters were studied, focusing on ghrelin concentrations at baseline and 6, 12, and 24 months post-BS.


At 24 months post-BS, all metabolic parameters studied had improved in all patients compared with those at 1-year follow-up and baseline (p < 0.05). However, high-density lipoprotein cholesterol concentrations took 2 years to normalise in 80% of patients, interleukin-6 decreased significantly in relation to baseline only after 2 years from BS (p < 0.001), and tumour necrosis factor alpha concentrations did not significantly decrease during the 2 years of follow-up. Plasma ghrelin concentrations increased in both surgical groups compare to baseline during the first year (24.6% in modified RYGBP and 36.62% in ringed RYGBP) and remained stable at the second year of follow-up, with no statistical differences between groups.


In the second year of follow-up after BS, morbidity continued to improve in MO patients despite a lesser weight loss in relation to the first year. An increase in plasma ghrelin concentrations was found, regardless of nutrient contact with gastric fundus. Furthermore, changes in plasma ghrelin concentrations appeared to be independent of weight loss.


Ghrelin Bariatric surgery Gastric fundus RYGBP Weight loss 


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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Noelia Pérez-Romero
    • 1
  • Assumpta Serra
    • 2
  • Maria Luisa Granada
    • 3
  • Miquel Rull
    • 4
  • Antonio Alastrué
    • 4
  • Maruja Navarro-Díaz
    • 2
  • Ramón Romero
    • 5
  • Jaime Fernández-Llamazares
    • 6
  1. 1.General Surgery DepartmentHospital Universitari Germans Trias i PujolBarcelonaSpain
  2. 2.Nephrology DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
  3. 3.Clinical Biochemistry DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
  4. 4.General Surgery DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
  5. 5.Chief of Nephrology DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
  6. 6.Cathedratic of Surgery of Barcelona Autonomous University and Chief of General Surgery DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain

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