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Gastric Bypass Results Better with Omentectomy

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MedPage today published an article this week about a randomized study finding that in non-diabetic, severely obese patients, adding omentectomy to laparoscopic Roux-en-Y gastric bypass provides some short-term metabolic benefits, in addition to the weight loss.  An omentectomy is a surgery to remove part or all of the omentum, a layer of fatty tissue which is attached to the stomach and abdominal organs.  The surgery was found to provide improvements to fasting glucose and cholesterol 90 days following surgery, compared to patients undergoing bariatric surgery alone.

The study findings were presented at the American Association of Clinical Endocrinologists’ 20th Annual Meeting and Clinical Congress last week. The study included 28 adult patients who either underwent a Roux-en-Y gastric bypass to receive a total omentectomy (15 patients) or not (13 patients). All of the patients had a Body Mass Index (BMI) of 40 to 50 without comorbidities or a BMI of 35 to 50 with comorbidities. At 90 days, the groups has similar weight loss, however, the omentectomy group had significant reductions in fast glucose and total cholesterol, while the control group did not.

Dr. Emma Patterson, bariatric surgeon and senior author of the trial, was available for comment: “The results of this study are exciting, as this is the first trial in humans to show that adding omentectomy to gastric bypass results in greater improvements in glucose homeostasis, lipid levels and adipokine profile compared with gastric bypass surgery alone. Other studies have not shown these differences, possibly due to smaller sample sizes, different timing of follow-up testing, or less complete omentectomies.”

When asked about the future potential of omentectomy, Patterson says, “This was a small pilot study with short-term follow-up. It is, however, significant that we found any metabolic differences in these patients, given that they all underwent gastric bypass surgery, which confers very powerful metabolic effects. If omentectomy has any future, I think it won’t likely be combined with gastric bypass surgery, but perhaps with less drastic procedures such as gastric banding or sleeve gastrectomy, or possibly as a stand-alone procedure. Our results are hopefully enough to encourage further studies on omentectomy, or selective visceral adipose tissue (VAT) reduction. VAT is important as it predicts incipient diabetes and cardiovascular disease.”

You can read MedPage Today’s article here.



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