Advertisement

Obesity Surgery

, Volume 19, Issue 11, pp 1504–1507 | Cite as

Treatment with Sibutramine prior to Roux-en-Y Gastric Bypass leads to an Improvement of Metabolic Parameters and to a Reduction of Liver Size and Operative Time

  • Jens Aberle
  • Anna Freier
  • Philipp Busch
  • Nina Mommsen
  • Frank U. Beil
  • Viola Dannheim
  • Oliver Mann
Clinical Report

Abstract

Background

Previous studies have shown that a preoperative weight loss is associated with better long-term outcome, fewer complications, and less time in the operating room in bariatric patients. However, preoperative weight loss is hard to achieve in many patients.

Methods

We, therefore, conducted a study in which 20 bariatric patients received 15 mg of the weight loss medication sibutramine prior to laparoscopic Roux-en-Y gastric bypass (RYGBP) while patients in the control group did not. It was our interest to find out if these patients had a benefit compared to a control group who did not receive medication.

Results

Whereas patients in the sibutramine group lost 4.8 kg within 6 weeks, patients in the control group gained 7.0 kg. Along with the change in weight, the size of the left liver lobe decreased in the sibutramine-treated patients and increased in the control group. Glutamic pyruvic transaminase as a parameter of liver function improved with reduction of liver size. Finally, time in the operating room was shorter for patients with preoperative weight loss due to sibutramine intake.

Conclusions

Medical therapy with sibutramine in preparation for bariatric surgery can improve the health status of patients and lead to a reduction of liver size and operating time. It should be considered as an alternative or addition to dietary therapy or gastric balloon treatment in the preparation of patients expecting a RYGBP.

Keywords

Sibutramine Preoperative Weight loss Obesity Roux-en-Y gastric bypass RYGBP 

References

  1. 1.
    Calle EE, Thun MJ, Petrelli HM, et al. Body-mass index and mortality in a prospective cohort of U.S. adult. N Engl J Med. 1999;341:1097–105.CrossRefGoogle Scholar
  2. 2.
    Anonymous. NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.CrossRefGoogle Scholar
  3. 3.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2005;293(14):1724–37.CrossRefGoogle Scholar
  4. 4.
    Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.CrossRefGoogle Scholar
  5. 5.
    Huerta S, Dredar S, Hayden E, et al. Preoperative weight loss decrease the operative time of gastric bypass at a veterans administration hospital. Obes Surg. 2008;18:508–12.CrossRefGoogle Scholar
  6. 6.
    Alverado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1282–6.CrossRefGoogle Scholar
  7. 7.
    Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18(7):772–5.CrossRefGoogle Scholar
  8. 8.
    Doucet E, St-Peirre S, Almeras N, et al. Reduction of visceral adipose tissue during weight loss. Eur J Clin Nutr. 2002;56:297–304.CrossRefGoogle Scholar
  9. 9.
    Fris RJ. Preoperative low energy diet diminishes liver size. Obes Surg. 2004;14:1165–70.CrossRefGoogle Scholar
  10. 10.
    Liu RC, Sabnis AA, Forsyth C, et al. The effects of acute preoperative weight loss on laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1396–402.CrossRefGoogle Scholar
  11. 11.
    James WP, Astrup A, Finer N, et al. Effect of sibutramine on weight maintenance after weight loss: a randomized trial. STORM study group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet. 2000;356(9248):2119–25.CrossRefGoogle Scholar
  12. 12.
    Schauer PR, Ikramuddin S, Hamd G, et al. Laparoscopic gastric bypass surgery: current technique. J Laparoendosc Adv Surg Tech A. 2003;13(4):229–39.CrossRefGoogle Scholar
  13. 13.
    Wittgrove AC, Clark GW. Laparoscopic gastric bypass: endostapler transoral or transabdominal anvil placement. Obes Surg. 2000;10(4):376–7.CrossRefGoogle Scholar
  14. 14.
    Livingstone EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82.CrossRefGoogle Scholar
  15. 15.
    Dronge AS, Perkal MF, Kancir S, et al. Long-term glycemic control and postoperative infectious complications. Arch Surg. 2006;141(4):375–80.CrossRefGoogle Scholar
  16. 16.
    Sjöström L. Surgical intervention as a strategy for treatment of obesity. Endocrine. 2000;13:213–30.CrossRefGoogle Scholar
  17. 17.
    Busetto L, Segato G, De Luca M, et al. Preoperative weight loss by intragastric balloon in super-obese patients treated with laparoscopic gastric banding: a case–control study. Obes Surg. 2004;14(5):671–6.CrossRefGoogle Scholar
  18. 18.
    Weiner R, Gutberlet H, Bockhorn H. Preparation of extremely obese patients for laparoscopic gastric banding by gastric balloon therapy. Obes Surg. 1999;9:261–4.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Jens Aberle
    • 1
  • Anna Freier
    • 1
  • Philipp Busch
    • 1
  • Nina Mommsen
    • 1
  • Frank U. Beil
    • 1
  • Viola Dannheim
    • 1
  • Oliver Mann
    • 1
  1. 1.Zentrum für Innere Medizin und Zentrum für Operative Medizin, Interdisziplinäres Adipositas ZentrumUniversitätsklinikum Hamburg-EppendorfHamburgGermany

Personalised recommendations