چکیده (انگلیسی):

Background: It is well established that severe hypertriglyceridemia can lead to
pancreatitis. At present, medical treatment for patients with severe hypertriglyceridemia
and repeat pancreatitis attacks is not adequate. The aim of this study was to assess the effectiveness
of laparoscopic bariatric surgery in these patients.
Methods: A review of 20 morbidly obese patients with severe hypertriglyceridemia (a triglyceride
level of >1000 mg/dL) who received laparoscopic bariatric surgery was performed. The
study population comprised 14 males and six females, with an average age of 35.0 years (range
24e52 years), and the mean body mass index was 38.2 kg/m2 (range 25e53 kg/m2
). The preoperative
mean plasma triglyceride level was 1782.7 mg/dL (range 1043e3884 mg/dL). Four
patients had a history of hypertriglyceridemic pancreatitis and 13 patients had associated diabetes.
Results: Of the 20 patients, 17 (85%) received gastric bypass, whereas three (15%) received
restrictive-type surgery. Laparoscopic access was used in all of the patients. Hypertriglyceridemia
in morbidly obese patients was more commonly associated with male sex and a poorly
controlled diabetic state. The mean weight reduction was 25.5% 1 year after surgery, with a
marked improvement in diabetes management. As early as 1 month following surgery, the
plasma mean triglyceride levels had decreased to 254 mg/dL (range 153e519 mg/dL), and this
was further reduced to mean levels of 192 mg/dL (range 73e385 mg/dL) 1 year after surgery.
One patient developed acute pancreatitis during the perioperative period, but none of the patients
suffered an episode of pancreatitis in the follow-up period (from 6 months to 13 years).
Conclusion: Bariatric surgery can be successfully used as a metabolic surgery in severe hypertriglyceridemia
patients at risk of acute pancreatitis. However, control of triglyceride levels
prior to bariatric surgery is indicated.