Skip to main content
SpringerLink
Log in

Gastric Plication and Sleeve Gastrectomy in an Experimental Model of Obesity: New Insights into Weight Loss, Intake and Metabolic Results

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Aim

Laparoscopic gastric plication (LGP) is a bariatric surgical technique based on the anatomical principles of laparoscopic sleeve gastrectomy (LSG), but its effects on the metabolic profile are still uncertain. The aim of our study is to compare the changes in weight, metabolic parameters and gastric histology following intervention by gastric plication (GP) and sleeve gastrectomy (SG) in an experimental model of obesity.

Methods

To conduct the study, 32 8-week-old male Sprague-Dawley rats (Charles River®) were fattened by means of a cafeteria diet and randomly assigned to the following experimental groups: group 1: GP (n = 12); group 2: SG (n = 12) and group 3: sham (n = 8).

Results

Unlike the SG group, the GP group attained the weight of the sham group at the end of the experiment (week 16). The GP group continued to eat more cafeteria diet than the SG group. In addition, the SG group achieved better glycaemic control than the GP group. Significantly higher plasma ghrelin levels were observed at week 16 in the GP group than in the SG group (2.29 ± 0.5 vs 1.07 ± 0.4, p < 0.05), which also occurred for the glucagon plasmatic levels (62.71 ± 36.2 vs 24.63 ± 9.3, p < 0.05).

Conclusions

GP is not as effective as SG and cannot be considered a metabolic surgery due to observed hormonal variations. The animals subjected to a GP continued to have a high appetite for the cafeteria diet unlike the animals submitted to an SG. Hormonal mechanisms possibly related to glucagon and ghrelin may be involved in this metabolic response.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kirk RM. An experimental trial of gastric plications as a means of weight reduction in the rat. Br J Surg. 1969;56:930–3.

    Article  PubMed  CAS  Google Scholar 

  2. Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017 Feb;13(2):170–80.

    Article  PubMed  Google Scholar 

  3. Angrisani L, Santonicola A, Iovino P, et al. Endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27:2279–89. https://doi.org/10.1007/s11695-017-2666-x.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Talebpour M, Sadid D, Talebpour A, et al. Comparison of short-term effectiveness and postoperative complications: laparoscopic gastric plication vs laparoscopic sleeve gastrectomy. Obes Surg. 2017;28:996–1001. https://doi.org/10.1007/s11695-017-2951-8.

    Article  Google Scholar 

  5. Bradnova O, Kyrou I, Hainer V, et al. Laparoscopic greater curvature plication in morbidly obese women with type-2 diabetes: effects on glucose homeostasis, postprandial trygliceridemia and selected gut hormones. Obes Surg. 2014;24:718–26.

    Article  PubMed  Google Scholar 

  6. Ji Y, Wang W, Zhu J, et al. A systematic review of gastric plication for the treatment of obesity. Surg Obes Relat Dis. 2014;10:1226–32.

    Article  PubMed  Google Scholar 

  7. Menchaca HJ, Harris JL, Thompson SE, et al. Gastric plication: preclinical study of durability of serosa-to-serosa apposition. Surg Obes Relat Dis. 2011 Jan-Feb;7(1):8–14.

    Article  PubMed  Google Scholar 

  8. Sabench Pereferrer F, Hernàndez Gonzàlez M, Del Castillo Déjardin D. Experimental metabolic surgery: justification and technical aspects. Obes Surg. 2011 Oct;21(10):1617–28.

    Article  PubMed  Google Scholar 

  9. Sabench Pereferrer F, Vives Espelta M, Cabrera Vilanova A, et al. Duodeno-jejunal tube placement in an experimental model of obesity: effects on food behaviour and basal energy expenditure. Obes Surg. 2015 Jan;25(1):55–63.

    Article  PubMed  Google Scholar 

  10. Hussain A, El-Hasani S. Revisional surgery following laparoscopic gastric plication. Obes Surg. 2017;27:2692–3. https://doi.org/10.1007/s11695-017-2827-y.

    Article  PubMed  Google Scholar 

  11. Fusco PE, Poggetti RS, Younes RN, et al. Evaluation of gastric greater curvature invagination for weight loss in rats. Obes Surg. 2006;16:172–7.

    Article  PubMed  Google Scholar 

  12. Suzuki S, Ramos EJ, Goncalves CG, et al. Changes in GI hormones and their effect on gastric emptying and transit times after Roux-en-Y gastric bypass in rat model. Surgery. 2005;138(2):283–90.

    Article  PubMed  Google Scholar 

  13. Kadera BE, Portenier DD, Yurcisin BM, et al. Evidence 218 for a metabòlic mechanism in the improvement of type 2 diabetes after sleeve gastrectomy in a rodent model. Surg Obes Relat Dis. 2013;9:447–52.

    Article  PubMed  Google Scholar 

  14. Wilson-Pérez HE, Chambers AP, Sandoval DA, et al. The effect of vertical sleeve gastrectomy on food choice in rats. Int J Obes. 2013;37:288–95.

    Article  CAS  Google Scholar 

  15. Chambers AP, Wilson-Perez HE, McGrath S, et al. Effect of vertical sleeve gastrectomy on food selection and satiation in rats. Am J Physiol Endocrinol Metab. 2012;303:1076–84.

    Article  CAS  Google Scholar 

  16. Pressler JW, Haller A, Sorrell J, et al. Vertical sleeve gastrectomy restores glucose homeostasis in apolipoprotein A-IV KO mice. Diabetes. 2015;64:498–507.

    Article  PubMed  CAS  Google Scholar 

  17. Casajoana A, Pujol J, Garcia A, et al. Predictive value of gut peptides in T2D remission: randomized controlled trial comparing metabolic gastric bypass, sleeve gastrectomy and greater curvature plication. Obes Surg. 2017 Sep;27(9):2235–45.

    Article  PubMed  Google Scholar 

  18. Bužga M, Švagera Z, Tomášková H, et al. Metabolic effects of sleeve gastrectomy and laparoscopic greater curvature plication: an 18-month prospective, observational, open-label study. Obes Surg. 2017 Jul 3;27:3258–66. https://doi.org/10.1007/s11695-017-2779-2.

    Article  PubMed  Google Scholar 

  19. Anderson B, Switzer NJ, Almamar A, et al. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg. 2013;23:1476–80.

    Article  PubMed  Google Scholar 

  20. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22:740–8.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Nannipieri M, Baldi S, Mari A, et al. Roux-en-Y gastric bypass and sleeve gastrectomy: mechanisms of diabetes remission and role of gut hormones. J Clin Endocrinol Metab. 2013;98:4391–9.

    Article  PubMed  CAS  Google Scholar 

  22. Lee WJ, Chen CY, Chong K, et al. Changes in postprandial gut hormones after metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:683–90.

    Article  PubMed  Google Scholar 

  23. Ma GJ, Zhang W, Zheng XM, et al. Establishment of sleeve gastrectomy model in diet-induced obese Sprague-Dawley rats. Zhonghua Wei Chang Wai Ke Za Zhi. 2012;15:43–6.

    PubMed  Google Scholar 

  24. Patrikakos P, Toutouzas KG, Perrea D, et al. A surgical rat model of sleeve gastrectomy with staple technique: long-term weight loss results. Obes Surg. 2009;19:1586–90.

    Article  PubMed  Google Scholar 

  25. Eickhoff H, Louro TM, Matafome PN, et al. Amelioration of glycemic control by sleeve gastrectomy and gastric bypass in a lean animal model of type 2 diabetes: restoration of gut hormone profile. Obes Surg. 2015;25:7–18.

    Article  PubMed  Google Scholar 

  26. Wang Y, Liu J. Plasma ghrelin modulation in gastric band operation and sleeve gastrectomy. Obes Surg. 2009;19:357–62.

    Article  PubMed  Google Scholar 

  27. Li F, Zhang G, Liang J, et al. Sleeve gastrectomy provides a better control of diabetes by decreasing ghrelin in the diabetic Goto-Kakizaki rats. J Gastrointest Surg. 2009 Dec;13(12):2302–8.

    Article  PubMed  Google Scholar 

  28. Rodríguez A, Becerril S, Valentí V, et al. Short-term effects of sleeve gastrectomy and caloric restriction on blood pressure in diet-induced obese rats. Obes Surg. 2012;22:1481–90.

    Article  PubMed  Google Scholar 

  29. Masuda T, Ohta M, Hirashita T, et al. A comparative study of gastric banding and sleeve gastrectomy in an obese diabetic rat model. Obes Surg. 2011;21:1774–80.

    Article  PubMed  Google Scholar 

  30. Zhou D, Jiang X, Ding W, et al. Impact of bariatric surgery on ghrelin and obestatin levels in obesity or type 2 diabetes mellitus rat model. J Diabetes Res. 2014;2014:569435.

    PubMed  PubMed Central  Google Scholar 

  31. Rubino F, Zizzari P, Tomasetto C, et al. The role of the 231 small bowell in the regulation of circulating ghrelin levels and food intake in the obese Zucker rat. Endocrinology. 2005;146:1745–55.

    Article  PubMed  CAS  Google Scholar 

  32. Solomou S, Korbonits M. The role of ghrelin in weight-regulation disorders: implications in clinical practice. Hormones. 2014;13:458–75.

    PubMed  Google Scholar 

  33. Ivano FH, Silva Lde M, Seniski GG, et al. Comparison of gherkin plasma levels between pre and postoperative period in patients submitted to gastric plication associated with fundoplication. ABCD Arq Bras Cir Dig. 2013;26:8–12.

    Article  PubMed  Google Scholar 

  34. Hansen T, Dall R, Hosoda H. Weight loss increases circulating levels of ghrelin in human obesity. Clin Endocrinol. 2002;56:203–6.

    Article  CAS  Google Scholar 

  35. Briggs D, Andrews Z. Metabolic status regulates gherkin function on energy homeostasis. Neuroendocrinology. 2011;93:48–57.

    Article  PubMed  CAS  Google Scholar 

  36. Griffo E, Cotugno M, Nosso G, et al. Effects of sleeve gastrectomy and gastric bypass on postprandial lipid profile in obese type 2 diabetic patients: a 2-year follow-up. Obes Surg. 2016 Jun;26(6):1247–53.

    Article  PubMed  CAS  Google Scholar 

  37. Basso N, Capoccia D, Rizzello M, et al. First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: the gastric hypothesis. Surg Endosc. 2011;25:3540–50.

    Article  PubMed  CAS  Google Scholar 

  38. Dimitriadis E, Daskalakis M, Kampa M, et al. Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study. Ann Surg. 2013;257:647–54.

    Article  PubMed  Google Scholar 

  39. Brinckerhoff TZ, Bondada S, Lewis CE, et al. Metabolic effects of sleeve gastrectomy in a female rat model of diet-induced obesity. Surg Obes Relat Dis. 2013;9:108–12.

    Article  PubMed  Google Scholar 

  40. Chambers A, Smith E, Begg D, et al. Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy. Am J Physiol Endocrinol Metab. 2014;306:424–32.

    Article  CAS  Google Scholar 

  41. Vives M, Molina A, Danús M, et al. Analysis of gastric physiology after laparoscopic sleeve gastrectomy (LSG) with or without antral preservation in relation to metabolic response: a randomised study. Obes Surg. 2017 Nov;27(11):2836–44.

    Article  PubMed  CAS  Google Scholar 

  42. Gagner M. Faster gastric emptying after laparoscopic sleeve gastrectomy. Obes Surg. 2010;20(7):964–5.

    Article  PubMed  Google Scholar 

  43. Jiang G, Zhang B. Glucagon and regulation of glucose metabolism. Am J Physiol Endocrinol Metab. 2003;284:671–8.

    Article  Google Scholar 

  44. Bansal P, Wang Q. Insulin as a physiological modulator of glucagon secretion. Am J Physiol Endocrinol Metab. 2008;295:751–61.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, “Rovira i Virgili” University, Reus, Tarragona, Spain

    A Cabrera, M Vives, A Molina, M París, E Raga, A Sánchez, F Sabench & D. Del Castillo

Authors
  1. A Cabrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Vives
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Molina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M París
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E Raga
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F Sabench
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. Del Castillo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to F Sabench or D. Del Castillo.

Ethics declarations

All procedures performed are in accordance with the experimental ethical standards of the institutional research committee (Generalitat de Catalunya-registration number 3522).

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cabrera, A., Vives, M., Molina, A. et al. Gastric Plication and Sleeve Gastrectomy in an Experimental Model of Obesity: New Insights into Weight Loss, Intake and Metabolic Results. OBES SURG 28, 3259–3267 (2018). https://doi.org/10.1007/s11695-018-3340-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-018-3340-7

Keywords

Search

Navigation