Review| Volume 62, ISSUE 6, P761-767, June 2013

A case report and review of the literature of laparoscopic sleeve gastrectomy in morbidly obese adolescents: Beyond metabolic surgery and visceral fat reduction

  • Author Footnotes
    1 Both authors contributed equally.
    Susann Blüher
    Corresponding author. Department of Women and Child Health/IFB Adiposity Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany. Tel.: +49 341 97 26 310; fax: +49 341 97 26 329.
    1 Both authors contributed equally.
    Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Germany

    Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Germany
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally.
    Matthias Raschpichler
    1 Both authors contributed equally.
    Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Germany

    Department of Radiology, University of Leipzig, Germany
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  • Wolfgang Hirsch
    Department of Radiology, University of Leipzig, Germany
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  • Holger Till
    Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Germany

    Department of Women and Child Health, Hospital for Pediatric Surgery, University of Leipzig, Germany
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally.
Published:December 10, 2012DOI:



      Data on safety, effectiveness and amelioration of metabolic comorbidities are scarce for adolescents undergoing laparoscopic sleeve gastrectomy (LSG).


      Data on a 17 year-old female who underwent LSG due to morbid obesity and quantification of visceral adipose tissue (VAT)/hepatic fat (HF) by MRI scan are presented. In addition, a review of the literature related to LSG in adolescent obesity is provided [search terms: laparoscopic sleeve gastrectomy, adolescence, obesity].


      Pre-existing comorbidities in our patient included insulin resistance, NASH (HF: 28%) and hyperuricemia. BMI dropped from 52.9 kg/m2 to 40.4 and 35.0 kg/m2 after 6 and 24 months, respectively, following LSG. VAT dropped by 49.2% and by 71.5% within 6 and 24 months, accompanied by a decrease of HF to 1.53% and to 0.85%, respectively. Improvements of metabolic parameters towards normal range, which were reached within 6 months following LSG, could be maintained for 2 years. The review of the literature revealed that 9 original papers on LSG in adolescent obesity are available to date, ranging from single case presentations to case series of 108 patients and including children and adolescents 8–18 years.


      LSG is a safe and – in the short term – effective bariatric procedure for adolescent obesity (follow up 24 months). Long-term results with larger numbers of patients and involving additional features, such as quantification of VAT and HF as markers of metabolic risk and insulin resistance, are warranted to further understand the effectiveness and safety and to further explore the long-term benefits of this procedure in adolescence.


      AAT (Abdominal adipose tissue), BMI (Body Mass Index), BPD (Biliopancreatic diversion), BMI-SDS (Standard deviation score of body mass index), FFA (Free fatty acids), 1H MRS (1H magnetic resonance spectroscopy), HF (Hepatic fat), HOMA-IR (Homeostasis model assessment of insulin resistance), LSG (Laparoscopic sleeve gastrectomy), MRI (Magnetic resonance imaging), NAFLD (Nonalcoholic fatty liver disease), NASH (Nonalcoholic steatohepatitis), OGTT (Oral glucose tolerance test), RYGBP (Roux-en-Y gastric bypass), SAT (Subcutaneous adipose tissue), sUA (Serum uric acid), VAT (Visceral adipose tissue)


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