Purpose: Laparoscopic sleeve gastrectomy has proven effectiveness regarding weight reduction, but metabolic consequences, especially in the long-term, have not yet been adequately clarified. The aim of the present study is to examine metabolic changes after laparoscopic sleeve gastrectomy in a two-year prospective survey. 

Methods: Eighty-one patients were examined before laparoscopic sleeve gastrectomy and 3, 6, 12, 18, and 24 months postoperatively. Different markers of metabolic diseases including blood lipids and liver enzymes, inflammation markers and markers of glucose metabolism were assessed.  

Results: Body weight was significantly reduced from 144.4 ± 23.0 kg before surgery to 101.3 ± 20.0 kg 24 months postoperatively. Excess weight loss  after 24 months was 58 ± 20 % in our study population. Besides body weight changes, significant improvements were found for triglycerides (p < 0.001), low density lipoprotein cholesterol (p < 0.01), and high density lipoprotein cholesterol  (p < 0.001). Moreover, C-reactive protein and leukocytes, as well as the liver enzymes improved in the 2-yearscourse (all p < 0.001). These changes resulted in a sharp reduction of the prevalence of the metabolic syndrome from 69 to 26 % (p < 0.001). Furthermore, the number of patients with hypertension and diabetes – assessed by fasting glucose and glycated hemoglobin –, were reduced to less than half. 

Conclusions: Laparoscopic sleeve gastrectomy improves lipid profile and liver enzyme status, and reduces signs of inflammation in obese patients within 2 years. These changes suggest a significant risk reduction of metabolic diseases in obese patients undergoing laparoscopic sleeve gastrectomy.