Abstract
Objective
Data on safety, effectiveness and amelioration of metabolic comorbidities are scarce
for adolescents undergoing laparoscopic sleeve gastrectomy (LSG).
Methods
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].
Results
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.
Conclusions
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.
Abbreviations:
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)Keywords
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Article info
Publication history
Published online: December 10, 2012
Accepted:
November 6,
2012
Received:
August 11,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
