Page 12 - World Journal of Laparoscopic Surgery

Bariatric Surgery and Obesity
1 patient (5.88%) (Fig. 1). Thepatients were kept on a follow-up for ratio, which were noted preoperatively and at 4 weeks and 3 months
3 months from the date of surgery. Particulars and demographic postoperatively. The laboratory investigations included HbA1c and
data of each patient were duly noted including their name, age, lipid profile, e.g., serum triglycerides, serum cholesterol, serum HDL,
sex, occupation, admission number, occupation, and address for serum LDL, and serum VLDL.
any future correspondence (Table 2). Patients presenting included in the study underwent
The detailed history of each patient was obtained including hematological, biochemical, and radiological investigations. For
history of presenting symptoms, any preexisting comorbid this, patients included in the study were informed regarding their
conditions, and the patient’s past history including treatment and inclusion, and a written informed consent was obtained from all
surgical history. the patients included in the study.
General physical examination and a thorough systemic
examination of all patients were carried out at the time of admission. results
All the necessary routine preliminary investigations were done. All Effect on Anthropometric Parameters
patients underwent specific anthropometric measurements such as Weight was measured before surgery, at 4 weeks, and 3 months
weight, BMI, waist circumference, hip circumference, and waist–hip
after surgery as depicted in Table 3. Preoperatively mean weight
was 138.71 ± 17.51 kg. Significant weight loss was observed at 4
weeks and 3 months when mean weight was 130.47 ± 14.77 kg and
116.53 ± 15.64 kg, respectively, thus concluding that the procedure
of bariatric surgery results in effective weight loss.
Body mass index is calculated by weight (in kg) divided by
2
height (in m ). The patient becomes eligible for bariatric surgery
depending upon this main parameter. There was a marked decrease
in BMI of the patients at 4 weeks and 3 months postoperatively that
was highly statistically significant.
The waist circumference decreased from mean preoperative
132.94 cm to 126.47 cm at 4 weeks and to 106.93 cm at 3 months.
The mean hip circumference decreased from preoperative 124.50
cm to 119.14 cm at 4 weeks and 108.21 cm at 3 months. The waist:hip
ratio decreased from preoperative 1.06 cm to 1.05 cm at 4 weeks
and 0.98 cm at 3 months.

Effect on Biochemical Parameters
Fig. 1: Distribution of patients on the basis of procedure done There was a fall in HbA1c levels in patients (mean: 7.14 ± 2.62)
following bariatric surgery (Table 3). The fall in HbA1c levels at
Table 2: Demographic data 4 weeks (mean: 6.71 ± 2.22) and 3 months (mean: 5.57 ± 1.18)
Number (n) 17 postoperatively was significant in both the groups. Serum
Mean age (years) 43 ± 7.624 cholesterol levels showed a significant improvement (p = 0.003)
Mean height (m) 172.47 ± 6.09 at 4 weeks (mean: 209.47 ± 55.67 mg/dL) when compared with
preoperative levels (mean: 194.71 ± 47.17 mg/dL) and a highly
Mean weight (kg) 138.71 ± 17.51 significant improvement (p = 0.00) at 3 months (mean: 169.65 ±
2
Mean BMI (kg/m ) 46.67 ± 6.230 31.06 mg/dL). Serum triglyceride levels showed an improvement
Table 3: Value of various parameters before operation and after 4 weeks and 3 months of operation
Preoperative Preoperative
Preoperative 4 weeks 3 months vs 4 weeks vs 3 months
Parameters Mean SD Mean SD Mean SD p value p value
Weight (kg) 138.71 17.510 130.47 14.770 116.53 15.649 0.000 0.000
Weight loss – – 8.47 3.68 22.29 4.91
%EWL – – 12.96 4.04 36.11 8.99
Waist circumference 132.94 13.64 126.47 13.24 106.93 10.83 0.170 0.000
Hip circumference 124.50 8.28 119.14 7.96 108.21 7.48 0.063 0.000
Waist:hip ratio 1.06 0.06 1.05 0.06 0.98 0.05 0.630 0.002
BMI 46.67 6.230 43.95 5.317 38.67 4.610 0.000 0.000
HbA1c 7.14 2.628 6.71 2.222 5.57 1.181 0.008 0.002
Serum cholesterol 209.47 55.679 194.71 47.170 169.65 31.068 0.003 0.000
Triglyceride 305.47 76.81 287.70 70.87 250.88 63.08 0.488 0.030
HDL 25.23 5.70 29 5.91 38.94 8.16 0.067 0.0001
LDL 99.47 40.88 94.41 38.23 86 34.08 0.711 0.304
VLDL 37.23 15.91 35.82 14.79 32.47 11.87 0.790 0.330
SD, standard deviation

98 World Journal of Laparoscopic Surgery, Volume 12 Issue 3 (September–December 2019)