Treatment with sibutramine prior to Roux-en-Y gastric bypass leads to an improvement of metabolic parameters and to a reduction of liver size and operative time.

BACKGROUND: Previous studies have shown that a preoperative weight loss is associated with better long-term outcome, fewer complications, and less time in the operating room in bariatric patients. However, preoperative weight loss is hard to achieve in many patients.

METHODS: We, therefore, conducted a study in which 20 bariatric patients received 15 mg of the weight loss medication sibutramine prior to laparoscopic Roux-en-Y gastric bypass (RYGBP) while patients in the control group did not. It was our interest to find out if these patients had a benefit compared to a control group who did not receive medication.

RESULTS: Whereas patients in the sibutramine group lost 4.8 kg within 6 weeks, patients in the control group gained 7.0 kg. Along with the change in weight, the size of the left liver lobe decreased in the sibutramine-treated patients and increased in the control group. Glutamic pyruvic transaminase as a parameter of liver function improved with reduction of liver size. Finally, time in the operating room was shorter for patients with preoperative weight loss due to sibutramine intake.

CONCLUSIONS: Medical therapy with sibutramine in preparation for bariatric surgery can improve the health status of patients and lead to a reduction of liver size and operating time. It should be considered as an alternative or addition to dietary therapy or gastric balloon treatment in the preparation of patients expecting a RYGBP.