Correlation Between the Number of Ghrelin-Secreting Cells in the Gastric Fundus and Excess Weight Loss after Sleeve Gastrectomy
Weight loss after laparoscopic sleeve gastrectomy (LSG) has been mainly attributed to the restriction of gastric volume; however; other factors may contribute to weight loss after LSG. This study aimed to investigate the correlation between the number of ghrelin-secreting cells in the gastric fundus and excess weight loss (EWL) at 12 months after LSG.
The surface area of the gastric fundus was measured postoperatively in square centimeter. Histopathologic examination of the gastric fundus was made to estimate the number of ghrelin-secreting cells per square centimeter then was multiplied by the surface area of the fundus to calculate the total number of ghrelin-secreting cells in the fundus. The number of ghrelin-secreting cells was correlated with EWL and BMI at 12 months postoperatively.
The present study included 39 patients of a mean age of 33.7 years. The mean %EWL at 12 months was 59.7 ± 12.7. The mean total number of ghrelin-producing cells in the gastric fundus was 26,228.4 ± 16,995.3. The total number of ghrelin-secreting cells had a weak positive correlation with BMI at 12 months (r = 0.2891, p = 0.07), and weak negative correlation with %EWL (r = − 0.1592, p = 0.33).
There was a weak correlation between the total number of ghrelin-producing cells in the gastric fundus and plasma ghrelin levels with EWL after LSG.
KeywordsLaparoscopic sleeve gastrectomy Ghrelin-secreting cells Fundus Correlation Weight loss
Hossam Elbanna and Abdulaziz Itlaybah designed the study and contributed to data collection and analysis and writing of the manuscript. Sameh Emile, Ahmed AbdelMawla, and Waleed Thabet contributed in data collection and analysis and writing of the manuscript. Wagdi Elkashef performed histopathologic examination of the gastric fundus for ghrelin-secreting cells and contributed to data collection and analysis. Haitham Elkaffas contributed to data analysis, drafting, and revision of the manuscript. Noha Abdelsalam contributed to follow-up of patients, providing nutritional support after surgery, data collection, and drafting of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Statement of Informed Consent
Informed consent was obtained from all individual participants included in the study.
Statement of Human and Animal Rights
This study was conducted in accordance with the declaration of Helsinki. Ethical approval for the study was obtained from the Institutional Review Board (IRB) of Mansoura Faculty of Medicine.
- 1.Vardar E, Öztürk AM, Ersoz D, et al. Routine careful histopathological examination should be performed in sleeve gastrectomy specimens. J Health Sci. 2017;7(1):44–9.Google Scholar
- 2.Emile SH, Elfeki H, Elalfy K, et al. Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech. 2017;00:000–0.Google Scholar
- 3.Elbanna HG, Emile SH, El-Hawary GES, et al. Assessment of the correlation between preoperative and immediate postoperative gastric volume and weight loss after sleeve gastrectomy using computed tomography volumetry. World J Surg. 2018; https://doi.org/10.1007/s00268-018-4749-9. [Published ahead of print]
- 8.Vigneshwaran B, Wahal A, Aggarwal S, et al. Impact of sleeve gastrectomy on type 2 diabetes mellitus, gastric emptying time, glucagon-like peptide 1 (GLP-1), ghrelin and leptin in non-morbidly obese subjects with BMI 30–35.0 kg/ m2 : a prospective study. Obes Surg. 2016;26(12):2817–23.CrossRefGoogle Scholar
- 11.Mahmoud SA, Hussein AF, Omar W, et al. Gastric mucosal changes and ghrelin expression and their relation to weight reduction after sleeve gastrectomy. J Surg. 2018;6(2):36–42.Google Scholar
- 15.Braghetto I, Burgos AM, Gutiérrez L, et al. Length and Volume of the resected stomach in patients with morbid obesity submitted to Sleeve Gastrectomy or resective Gastric Bypass compared to Controls. BMI - Bariátrica E Metabólica Iberoam. 2011;1:9–13.Google Scholar
- 22.Rosas et al. The influence of resected gastric weight upon weight loss after sleeve gastrectomy. Am Surg. 2015;81(12):1240–3.Google Scholar