Volume 6, Issue 2, April 2018, Page: 36-42
Gastric Mucosal Changes and Ghrelin Expression and Their Relation to Weight Reduction After Sleeve Gastrectomy
Sabry Ahmed Mahmoud, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Ahmed Fadaly Hussein, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Waleed Omar, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Emad Abdallah, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Wagdi Elkashef, Pathology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
Mohamed Anwar, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Sameh Emile, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Received: Feb. 6, 2018;       Accepted: Feb. 24, 2018;       Published: Mar. 19, 2018
DOI: 10.11648/j.js.20180602.12      View  2043      Downloads  92
Background: Weight loss after laparoscopic sleeve gastrectomy (LSG) is usually attributed to the volume restrictive effect of the procedure in addition to specific hormonal changes. Objective: The present study aimed to investigate the changes in plasma ghrelin levels, the number of ghrelin producing cells and histopathological changes in the remaining pouch after LSG. Methods: The present study included 27 patients with morbid obesity. The plasma ghrelin levels were measured before and six months after LSG and the change in their levels was assessed in relation to body mass index (BMI) after LSG. Immunohistochemical staining of cellular ghrelin was used to evaluate the number and distribution of ghrelin producing cells in the resected specimen and the mucosal changes in the remaining gastric pouch after LSG were assessed at 6 months postoperatively. Results: The mean age of patients was 33.9± 21.9 years. At six months after LSG, BMI decreased from 52.6± 12.8 to 40.8± 7.2 Kg/m2 (p= 0.0001). The plasma ghrelin level decreased significantly from 564.1± 15 to 434.7± 22.6 at six months after LSG. There was strong positive correlation between BMI after LSG and plasma ghrelin level (R= 0.906, p= <0.0001). A significant improvement in the inflammatory parameters was noticed by histopathologic examination. The mean ghrelin positive cell per specimen decreased significantly from 25.37± 3.5 to 13.7 ± 2.12. Conclusion: There was good positive correlation between weight loss and lowering of plasma ghrelin level, also complete removal of the fundus was associated with more weight loss.
Sleeve Gastrectomy, Mucosal Changes, Ghrelin, Weight Loss
To cite this article
Sabry Ahmed Mahmoud, Ahmed Fadaly Hussein, Waleed Omar, Emad Abdallah, Wagdi Elkashef, Mohamed Anwar, Sameh Emile, Gastric Mucosal Changes and Ghrelin Expression and Their Relation to Weight Reduction After Sleeve Gastrectomy, Journal of Surgery. Vol. 6, No. 2, 2018, pp. 36-42. doi: 10.11648/j.js.20180602.12
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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