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Omentectomy added to gastric bypass conveyed additional metabolic benefit
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American Association of Clinical Endocrinologists 20th Annual Meeting
SAN DIEGO — When omentectomy was added to Roux-en-Y gastric bypass surgery, it resulted in favorable changes in glucose homeostasis, lipid levels and adipokine profile at 90 days in patients without diabetes, researchers found.
“This remains an experimental procedure; however, it does highlight the importance of visceral adiposity and underscores the deleterious nature of intraabdominal fat in the obesity epidemic in this country,” Troy Dillard, MD, a fellow at Oregon Health & Science University in Portland, said at a press conference.
The American Association of Clinical Endocrinologists designated Dillard the 2011 meeting oral presentation winner. His research was chosen from a record number of posters submitted this year.
The small, randomized, controlled trial looked at the benefits of adding subtotal omentectomy to laparoscopic Roux-en-Y gastric bypass surgery vs. surgery alone in 28 patients without diabetes. The cohort was mostly women (n=21), and all had a BMI of 40 or greater with no comorbid conditions or 35 or greater with comorbid conditions. Dillard said this is the second largest trial studying omentectomy added to Roux-en-Y gastric bypass surgery.
At 90 days, BMI decreased significantly in both groups and did not differ at follow-up. However, only the omentectomy group experienced significant changes in fasting glucose (P<.05), total cholesterol (P=.004) and very-low-density cholesterol (P=.001) and an increase in the high-molecular-weight adiponectin to total adiponectin ratio (P=.013).
Similar effects were not seen in the Roux-en-Y gastric bypass surgery alone group, Dillard said.
“Neither of these findings can be explained by changes in BMI or inflammatory markers since the groups showed no meaningful differences in changes in these parameters,” according to the researchers.
Complications were low. The researchers reported gastroenterostomy in two patients in the omentectomy group and urinary retention in one patient in the surgery alone group.
Disclosure: Dr. Dillard reports no relevant financial disclosures.
For more information:
- Dillard T. Abstract 801. Presented at: American Association of Clinical Endocrinologists 20th Annual Meeting; April 13-17, 2011; San Diego.