Advances in Medicine and Biology. Volume 107

Childhood Obesity in the United Kingdom 109

complications in this meta-analysis, but data extracted from currently available
reports show complication rates of between 22%−33% for LRYGB [117, 118],
4.3% for LSG [119] and 10%−48% for LAGB [114, 120]. Additional
outcomes, summarized from the meta-analysis by Black, and the wider
literature, are shown by procedure and combined in Table 6 adapted from a
paper by Beamish et al. [121].

Table 6. Short-term outcomes following bariatric surgery in adolescents

Variable LRYGB LSG LAGB All procedures

(95% CI)

BMI reduction (kg/m2)

T2DM resolution (%)

OSA resolution (%)

HTN resolution (%)

Insulin resistance resolution (%)

PCOS resolution (%)

Dyslipidemia resolution (%)

Operative morbidity (%)

13.3–22.5

67 - 100

100

82 - 100

100

100

87 - 100

8 - 33

13.0–17.2

0 - 68

56 - 80

69 – 100

50 – 96

0

0 - 58

4.3

8.5–11.7

80 – 100

20 – 100

50 - 100

44 – 77

• 35 – 100
  10 – 48

13.5 (15.1–11.9)
0 - 100
20 - 100
50 - 100
44 - 100
0 – 100
0 - 100
4 – 48
LRYGB: Laparoscopic Roux-en-Y gastric bypass; LSG: laparoscopic sleeve
gastrectomy; LAGB: Laparoscoipc adjustable gastric band; CI: confidence
interval; BMI: body mass index;T2DM: type II diabetes mellitus; OSA:
obstructive sleep apnea; HTN: hypertension; PCOS: polycystic ovarian syndrome.
Based on studies with mean 12-month follow-up

As available reports typically contain a few subjects and limited follow-
up, the encouraging figures given above should be treated with caution. In the
study with the most long-term follow-up, the sparsely performed
malabsorptive procedure, biliopancreatic diversion (BPD) was used. A
longitudinal observation of 76 adolescents aged between 14−18 years (mean
16.8) for a mean duration of 11 (range 2–23) years showed impressive
prolonged weight loss (78% excess weight loss at longest follow-up), and
equally impressive comorbidity resolution: 100% resolution of diabetes and
dyslipidemia, and >80% resolution of hypertension [122]. In addition the
paper gave a good insight into the evolutionary process of a bariatric
procedure and associated improvements in outcomes as the authors concluded
that the incidence of protein malnutrition improved across the study.
Biliopancreatic diversion is not routinely used in childhood bariatric surgery in
the UK.
In a case series report from Sheffield in the UK, Sachdev et al. [123] in
2014 reported on six adolescent patients operated upon between 2004 and