Impact of biliopancreatic shunting in modification of Hess–Marceau on indices of lipidogram in patients, suffering morbid obesity and dyslipidemia


Keywords: morbid obesity; dyslipidemia; biliopancreatic shunting; results

Abstract

Objective. To study the impact of biliopancreatic shunting (BPSH) in modification of Hess–Marceau on indices of lipidogram in patients, suffering morbid obesity and dyslipidemia.

Маterials and methods. The investigation was based on data of clinical examination and results of surgical treatment in 100 patients, suffering morbid obesity, to whom BPSH in modification of Hess–Marceau was conducted. There were 60 women and 40 men. Middle age of the patients have constituted (45 ± 8.2) yrs old.

Resullts. Laboratory markers of predominantly atherogenic phenotypes of dyslipidemia were registered preoperatively in 75 (75%) patients. Median level of general cholesterol have lowered down from (6.14 ± 0.9) tо (3.7 ± 0.7) mmol/l, triglycerides – from (1.98 ± 0.9) tо (1.12 ± 0.4) mmol/l, regression of the atherogenecity coefficient – from (3.9 ± 0.9) tо (23 ± 1.1) in 60 mo after bariatric surgery (р < 0.05). The indices of lipidogram have normalized in 87.0%, and improved – in 13.0% of the patients.

Conclusion. BPSH in modification of Hess–Marceau constitutes a highly effective procedure for correction of dyslipidemia in patients, suffering morbid obesity.

References

1. World Health Organization. The top 10 causes of death. Available from: https://www.who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-death

2. Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham Study. Circulation.1979 Jan;59(1):8-13. PMID:758126

3. Neaton JD, Blackburn H, Jacobs D, Kuller L, Lee DJ, Sherwin R, et al. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial. Multiple Risk Factor Intervention Trial Research Group. Arch Intern Med. 1992 Jul; 152(7):1490-500. PMID:1627030

4. Wilson PW, D’Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005 Nov 15;112(20):3066-72. https://doi.org/10.1161/CIRCULATIONAHA.105.539528

5. Reaven GM. Banting Lecture: role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595-1607. PMID:3056758.

6. Gass M, Beglinger С, Peterli R. Metabolic surgery - principles and current concepts. Langenbecks Arch. Surg. 2011 Oct;396(7):949-972. https://doi.org/10.1007/s00423-011-0834-3.

7. Agrawal S, editor. Obesity, Bariatric and Metabolic Surgery. A practical guide. Cham: Springer; 2016. 736 p. https://doi.org/10.1007/978-3-319-04343-2

8. Karcz WK, Thomusch O, editors. Principles of Metabolic Surgery. Berlin, Heidelberg: Springer; 2012. 410 p. https://doi.org/10.1007/978-3-642-02411-5

9. O'Neill S, O'Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obes. Rev. 2015 Jan;16(1):1-12. https://doi.org/10.1111/obr.12229.

10. Kaur J. A comprehensive review on metabolic syndrome. Cardiol. Res. Pract. 2014; 2014:1-21. https://doi.org/10.1155/2014/943162.

11. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part 1: diagnosis and classification of diabetes mellitus. Geneva, Switzerland: World Health Organization; 1999. Available from: http://apps.who.int/iris/bitstream/handle/10665/66040/WHO_NCD_NCS_99.2.pdf

12. National Institutes of Health: Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Executive Summary. Bethesda, MD, National Institutes of Health, National Heart, Lung and Blood Institute, 2001 May. NIH publ. no. 01-3670. Available from: https://www.nhlbi.nih.gov/files/docs/guidelines/atp3xsum.pdf

13. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006 May;23(5):469-480. https://doi.org/10.1111/j.1464-5491.2006.01858.x

14. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Curr Opin Cardiol. 2006 Jan;21(1):1-6. PMID:16355022.

Author Biographies


I. M. Todurov, Centre of Innovative Medical Technologies NAS of Ukraine, Kyiv

Todurov I. M.: MD, DSci, professor,
director of Center for Innovative Medical Technologies
Kyiv, 04053 Voznesensʹkyy uzviz 22 st
+38 044 272 12 38
todurov@nas.gov.ua
https://orcid.org/0000-0001-6170-6056


O. V. Perekhrestenko, Centre of Innovative Medical Technologies NAS of Ukraine, Kyiv

Perekhrestenko O. V.: MD, PhD,
vice-director of Center for Innovative Medical Technologies,
Kyiv, 04053 Voznesenskyy uzviz 22 st
+38 044 272-50-06
perekhrestenko@nas.gov.ua
https://orcid.org/0000-0002-8240-7095.


S. V. Kosiuchno, Centre of Innovative Medical Technologies NAS of Ukraine, Kyiv

Kosiuchno S. V.: MD, PhD,
scientific chief department of minimally invasive surgery
Center for Innovative Medical Technologies,
Kyiv, 04053 Voznesenskyy uzviz 22 st
+38 044 272 2266
kosiukhno@nas.gov.ua
https://orcid.org/0000-0002-2950-9279


O. O. Kalashnikov, Centre of Innovative Medical Technologies NAS of Ukraine, Kyiv

Kalashnikov O. O.: MD, PhD,
head of surgical department,
Center for Innovative Medical Technologies,
Kyiv, 04053 Voznesenskyy uzviz 22 st
+38 044 272 2266
4542086@gmail.com
https://orcid.org/0000-0002-8224-8039


O. I. Plehutsa, Centre of Innovative Medical Technologies NAS of Ukraine, Kyiv

Plehutsa O. I.: MD, PhD,
senior researcher department of endocrine and metabolic surgery
Center for Innovative Medical Technologies,
Kyiv, 04053 Voznesensʹkyy uzviz 22 st
+38 044 272 21 86
plehutsamd@gmail.com
https://orcid.org/0000-0002-5695-6111

Published
2019-02-28
How to Cite
Todurov, I. M., Perekhrestenko, O. V., Kosiuchno, S. V., Kalashnikov, O. O., & Plehutsa, O. I. (2019). Impact of biliopancreatic shunting in modification of Hess–Marceau on indices of lipidogram in patients, suffering morbid obesity and dyslipidemia. Klinicheskaia Khirurgiia, 86(3), 11-14. https://doi.org/10.26779/2522-1396.2019.03.11
Section
General Problems of Surgery