Bariatric Surgery in the Management of Childhood Obesity: Should There be an Age Limit?

Abstract

We report a case of a 6-year-old girl suffering from morbid obesity, Blount;s disease, and significant social and functional impairment who underwent a laparoscopic sleeve gastrectomy. One year later, she has shown remarkable improvement in all aspects of her health emphasizing the success of the procedure. A follow-up laparoscopic Roux-en-Y gastric bypass or biliopancreatic diversion (BPD) are options if she regains weight as she gets older. This case is noteworthy for several reasons. The age of the patient is younger than any currently on record who has had this treatment. Additionally, the utilization of a sleeve gastrectomy as a first-step procedure, to be followed by Roux-en-Y gastric bypass or BPD, remains a novel treatment for morbid obesity in a pediatric population.

Laparoscopic Sleeve Gastrectomy in 108 Obese Children and Adolescents Aged 5 to 21 Years

“…16 There were no postoperative complications in reports of 8 children and adolescents who underwent LSG, with uneventful follow-up ranging from 9 to 19 months. [37][38][39][40][41] Our follow-up through 24 months also has not revealed any adverse safety outcomes. …”

“…To date, the use of LSG for treating severe obesity in adolescents and children has been reported in 4 case reports, a small (n = 4) case series, and 1 case that was included in a report of other surgical approaches. [37][38][39][40][41][42] After experiencing notable success with LSG in our adult patients, we began offering LSG as a primary surgical procedure for our morbidly obese pediatric patients at King Saud University Hospitals in 2008. This report of our experience comprises the largest series to date of LSG in children and adolescents, in which we assess patient characteristics, postoperative complications, short-term weight loss, resolution of comorbidities, and complications during up to 24 months of follow-up.…”

Long-Term Experience with Duodenal Switch in Adolescents

“…Specifically for children below 18 years of age, there are only 17 reported cases. The technique used varied from abandoned methods such as jejuno-ileal bypass [35,36]; vagotomy [37] in three; then Roux-Y gastric bypass in one [38], biliopancreatic diversion in eight [39][40][41]; duodenal switch (DS) in one [33]; and most recently, sleeve gastrectomy in one patient [42].…”

Managing obesity – from childhood and onwards

“…Others, on the other hand, argue for a greater success with earlier interventions (20). In 2009, a case report was published describing the use of vertical sleeve gastrectomy (VSG) as treatment of a six‐year‐old morbidly obese girl (21). Hence, bariatric surgery can technically be performed in young children.…”