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Obesity Surgery

, Volume 15, Issue 3, pp 367–377 | Cite as

Comparison of Changes in Lipid Profile after Bilio-intestinal Bypass and Gastric Banding in Patients with Morbid Obesity

  • Stefano Ginanni Corradini
  • Annarita Eramo
  • Carla Lubrano
  • Giovanni Spera
  • Alessandra Cornoldi
  • Antonio Grossi
  • Francesca Liguori
  • Maria Siciliano
  • Massimo Codacci Pisanelli
  • Gerald Salen
  • Ashok Kumir Batta
  • Adolfo Francesco Attili
  • Marco Badiali
Article

Background: The presence of hypercholesterolemia is currently not considered a selection criteria for performing gastric restrictive or diversionary bariatric surgery. Methods: We prospectively investigated the effects of the bilio-intestinal bypass (BI-bypass) with a wide cholecysto-jejunal anastomosis and of adjustable gastric banding (AGB) on blood lipid concentrations in obese patients. To clarify the mechanism of the hypocholesterolemic effect of the BI-bypass, daily fecal sterol excretion was measured by gas-liquid chromatography (GLC). Results: At 1 year after BI-bypass compared to baseline, the hypercholesterolemic (n=18) and the normocholesterolemic (n=19) patients significantly reduced total (−38% and −27%, respectively), LDL (−47% and −24%, respectively) and HDL (−11% and −13%, respectively) cholesterol and total / HDL cholesterol ratio (−25% and −13%, respectively). At 1 year after AGB, the total / HDL cholesterol ratio was significantly decreased (−11%) compared to baseline in hypercholesterolemic (n=12) but not in normocholesterolemic (n=6) patients, while total and LDL cholesterol were not affected in both groups. At 3 years after BI-bypass compared to baseline, the hypercholesterolemic (n=9) and the normocholesterolemic (n=11) patients significantly reduced total (−43% and −28%, respectively) and LDL (−53% and −29%, respectively) cholesterol and total / HDL cholesterol ratio (−38% and −21%, respectively). The BI-bypass induced a significant (P <0.005; n=7) 6-fold increase in mean fecal cholesterol output. Conclusions: The BI-bypass but not the AGB leads to a persistent and marked beneficial effect on blood LDL cholesterol associated with an increased cholesterol fecal output. BI-bypass but not AGB is indicated in morbidly obese patients with hypercholesterolemia.

BILIO-INTESTINAL BYPASS CHOLECYSTO-JEJUNAL ANASTOMOSIS GASTRIC BANDING BARIATRIC SURGERY MORBID OBESITY CHOLESTEROL MALABSORPTION TOTAL AND LDL CHOLESTEROL 

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Copyright information

© Springer 2005

Authors and Affiliations

  • Stefano Ginanni Corradini
    • Annarita Eramo
      • Carla Lubrano
        • Giovanni Spera
          • Alessandra Cornoldi
            • Antonio Grossi
              • Francesca Liguori
                • Maria Siciliano
                  • Massimo Codacci Pisanelli
                    • Gerald Salen
                      • Ashok Kumir Batta
                        • Adolfo Francesco Attili
                          • Marco Badiali

                            There are no affiliations available

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