Endocrine Abstracts

Background: Craniopharyngiomas are embryogenic malformations which lead to eating disorders and morbid obesity due to hypothalamic involvement. The experience with laparoscopic adjustable gastric banding (LAGB) in obese craniopharyngioma patients is limited especially in regard to long-term effects and tolerability.

Patients and methods: We are reporting on four patients with childhood craniopharyngioma diagnosed at age 2, 13, 12, and 20 years.

Results: Body mass index (BMI SDS) at diagnosis was −0.9, +4.5, +4.7 and +0.23 SD. All patients developed morbid obesity (BMI SDS: +10,87, +10.36, +11.4, +6,2) so that 11, 5, 9 and 3 years after diagnosis LAGB were performed. LAGB were well tolerated. During long-term follow-up, the nadir BMI SDS (+6.9, +9.5, +7.8, +4.9) were reached 2.0, 0.5, 1.0, 0.8 years after LAGB. At last evaluation 9.1, 5.3, 7.1, 7.1 years after LAGB, the patients BMI (BMI SDS at last evaluation: +10.2, +13.9, +10.2, +6.3) had increased again but remained at a constant level comparable with baseline BMI SDS at the time of LABG. Quality of life was not decreased due to LAGB and tolerability was sufficient.

Conclusions: We conclude that LAGB is feasible and could have clinical relevant effects on long-term weight stabilization of obese craniopharyngioma patients with hypothalamic syndrome. However, a significant weight reduction was not achieved after LAGB in patients with childhood craniopharyngioma. Non-reversible bariatric procedures such as gastric bypass are not recommended for treatment of obese children and adolescents with craniopharyngioma due to ethical considerations.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.