bariatric surgery

1. Monday,
January 23,
2023
1
Predicting gaining weight
after bariatric surgery
PROFESSOR DR. HIWA OMER AHMED
GENERAL AND BARIATRIC SURGERY
University of Sulaimani-College of
Medicine Kurdistan-Iraq

2. Monday,
January 23,
2023
2
Obesity and bariatric surgery
 In recent years, obesity has been recognized as a global epidemic and
is now becoming a worldwide health burden.
 Bariatric and metabolic surgery has provided satisfactory long-term
efficacy in weight loss, reducing cardiovascular risks and obesity-related
co-morbidities.
 Due to the advantages of good weight loss effect and technically easy
operation, laparoscopic sleeve gastrectomy (LSG) has now become the
most frequently used bariatric surgery type worldwide

3. Monday,
January 23,
2023
3
Regaining weight
 However, the high rate of weight regain after LSG is a
great challenge. Typically, weight regain usually starts
between 18 and 24 months postoperatively and the
rate of weight regain after 2 years ranges from 30% to
64%

4. Monday,
January 23,
2023
4
Biochemical parameters
 Λ cholesterol
 Λ CRP
 Λ SII
 V PNI

5. Monday,
January 23,
2023
5
Systemic inflammatory index
 SII
Calculated from
1. Neutrophil
2. Lymphocytes
3. Platelets
As following = platelets X Neutrophil/ Lymphocytes
When high it is indicated weight gain

6. Monday,
January 23,
2023
6
Prognostic nutritional index
 PNI
Calculated from
1. Lymphocytes
2. Serum albumin in grams
As following = albumin in grams + 5+ Lymphocytes
When low it is indicated weight gain

7. Monday,
January 23,
2023
7
Scoring
0 ^ SII, v PNI
1 ^SII< ^PNI
V SII, V PNI
2 V SII, ^ PNI
Low SII ≤ 390×109 cells/L
high SII > 390×109 cells/L
low PNI value (≤52.0)
high PNI value (>52.0)