Omentectomy Does not Improve Outcomes in Bariatric Surgery

Most people by now realize that visceral (intra-abdominal) fat accumulation is an important determinant of the cardiovascular and metabolic risk associated with excess weight (Visceral Fat Fattens Carotid Arteries, Jan 16, 2009)

The omentum is a large apron of fat inside the abdomen, which accounts for a large proportion of visceral fat. It is therefore only natural to ask the question whether surgical removal of this fat depot would be beneficial in patient with visceral obesity.

This question was now addressed in a randomized controlled trial in patients undergoing gastric bypass surgery for severe obesity (Obesity Surgery, April 2009).

In this study, Attila Csendes and colleagues from the University of Chile, Santiago, Chile, randomized 70 patients to laparotomic (open) resectional gastric bypass and an omentectomy.

Two years after surgery, no differences were seen in BMI levels in either group. Blood sugar levels, serum insulin, total cholesterol levels, serum triglycerides and blood pressure were similar in both groups.

Based on these results, omentectomy is not justified as part of bariatric surgery.

Given that previous small case series suggested that there may be some advantage to omentectomies, the “negative” results of this study documents the importance of conducting prospective randomized controlled studies.

Edmonton, Alberta