Ghrelin Levels and Hunger Sensation after Laparoscopic Sleeve Gastrectomy Compared with Laparoscopic Greater...

The aims of our study were to compare serum acylated ghrelin (the active form of ghrelin) concentrations before and after the surgery of patients undergoing laparoscopic sleeve gastrectomy (LSG) or laparoscopic greater curvature plication (LGCP) and to correlate these levels with excess weight loss and hunger sensations on a short-term basis.

The patients included in the study had either (1) a body mass index (BMI) over 35 kg/m2 and one comorbidity or (2) a BMI over 40 kg/m2. Ghrelin levels were measured on the day of the surgery, 1 month after the procedure, and 3 months after the procedure. A questionnaire about hunger sensation was administered to the patients, and changes in the patients' weights were evaluated on the same timeline as the measurement of the ghrelin levels.

Eighteen obese patients were included in the study, including 10 patients in the LSG group and 8 patients in the LGCP group. All the procedures were performed laparoscopically. The average level of preoperative ghrelin in the LSG group was 212.21 pg/mL ± 140.57 SD. After 1 month, the average ghrelin level in the LSG group was 74.47 pg/mL ± 29.55 SD (p = 0.01), and it was 41.47 pg/mL ± 15.19 SD (p = 0.002) after 3 months. The average level of preoperative ghrelin in the LGCP group was 318.08 pg/mL ± 161.70 SD. It decreased to 190.58 pg/mL ± 116.75 SD (p = 0.01) after 1 month and to 91.57 pg/mL ± 56.70 SD (p = 0.004) after 3 months. Comparing the two groups, hunger sensation had decreased more in the LSG group (p = 0.03) 3 months after the surgery.

Laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curvature plication (LGCP) produced the same weight loss and diminished hunger sensation in the short term on the selected patients. LSG had an increased effect on ghrelin levels when compared with LGCP at 1 month after the procedure and 3 months after the procedure.