Short-term outcome and early effect on blood pressure of laparoscopic sleeve gastrectomy in morbidly obese patients.

Bariatric surgery has been used to reduce weight and shown to be beneficial for hypertension control. However, little is known about the changes in blood pressure in early stage after laparoscopic sleeve gastrectomy (LSG). We conducted a prospective study of 60 LSG patients with one year-follow-up. The blood pressure of the patients was measured preoperatively and from day 1 to 12 months postoperatively. The use of antihypertensives, body weight, ghrelin and leptin levels were also recorded. Following LSG, excess weight loss (EWL) was 72.6 ± 22.3% and 83.1 ± 19.3% 6 and 12 months after operation, respectively. At 12 months after operation, the average body mass index and body weight decreased by 14.1 kg/m and 39 kg, respectively. Dyslipidemia was resolved in 86% (15/18) of the patients within 12 months. Diabetes was resolved in 90% (16/18) patients within 6 months and joint pain was resolved in 78% patients and 86% of the patients no longer had sleep apnea syndrome within 12 months. The blood pressure of some hypertensive patients returned to normal on the first day after operation. Significant reduction in blood pressure was observed within 10 days after operation. Both Ghrelin and Leptin levels lowered after LSG, particularly within 10 day after operation. 12 months after the operation, hypertension was resolved in 87% and lowered in 100% of the patients. Our work demonstrates that LSG reduces blood pressure before significant weight loss occurs, suggesting that there might be neural and hormonal mechanisms involved in the blood pressure reduction.