Laparoscopic adjustable gastric band for morbid obesity - local experience in Al-Ahsa region of Saudi Arabia

To present our experience of laparoscopic gastric banding [LAGB] for morbid obesity in the Eastern Province of Saudi Arabia Retrospective reviews of patients undergoing surgery for morbid obesity. King Fahad Hospital, Hofuf, Saudi Arabia One-hundred and eighty two [182] patients from January 2000 to December 2006 were included in the study. Laproscopic gastric banding Preoperative age, sex, body mass index [BMI], co-morbidities, operative variables and postoperative hospital stay and complications were recorded. The postoperative weight loss was recorded at three monthly intervals. The mean age was 30.3 years [range 18 - 51 years] and the mean BMI was 52.6 kg per square meter [range 41 - 61.5 kg per square meter]. There were two conversions to open procedure because of dense adhesions from previous surgeries. The mean operative time was 2.7 hours [range 1.25 - 3.5 hours]. The mean postoperative hospital stay was 3.7 days [range 2 - 12 days]. There was no mortality. Three patients had band removal after one year postoperatively. The mean follow up period was 11 months [range 3 - 40 months]. The mean BMI decreased to 50.2, 45.4, 41.2 and 37.7 kg per square meter at 3, 6, 9 and 12 months postoperatively, with an average excess weight loss reduction of 43.5% after one year. Conclusions: Laproscopic gastric banding is an effective and safe procedure for the treatment of morbid obesity in Saudi patients

Assessment of the relationship of hepatic enzymes with obesity and insulin resistance in adults in Saudi Arabia

This study was conducted to assess the relationship of hepatic enzymes and serum albumin to obesity and insulin resistance in adults in Saudi Arabia. A comparative study of 136 Saudi adults, comprising of 68 obese and 68 non-obese was conducted. Anthropometric measurements, hepatic enzymes, serum albumin, blood glucose, serum insulin, lipid profile, and homeostasis model assessment of insulin resistance [HOMA IR] were measured. The study showed significantly higher levels of gamma glutamyl transpeptidase [GGT], alkaline phosphatase, fasting glucose, serum insulin, and HOMA IR p < 0.001, <0.004 < 0.005, <0.0001, <0.0001, among obese subjects. Hepatic enzymes correlated with both anthropometric measures [body mass index [BMI], and waist to hip ratio] and markers of insulin resistance [HOMA IR, insulin, and fasting glucose]. However, the study found that GGT had the strongest associations. Significant inverse correlation was found between serum albumin and BMI, HOMA IR, and serum insulin, p< 0.01, <0.05, <0.01, respectively. Deranged liver functions, especially GGT, had the strongest correlations with obesity and HOMA IR. GGT might be a better marker of hepatic pathology associated with obesity and insulin resistance in Saudi adults with restricted alcohol intake. The results also propose that albumin metabolism might be altered in obesity