Fundus Functionality and Ghrelin Concentrations after Bariatric Surgery

To the Editor: Circulating ghrelin concentrations have been reported to be suppressed in morbidly obese patients after Roux-en-Y gastric bypass surgery,1 whereas no significant changes have been observed after adjustable gastric banding.2 The placement of an adjustable gastric band is a purely restrictive technique, producing an approximately 30-ml stomach pouch with functional conservation of the fundus. In contrast, gastric bypass surgery leaves a 15-ml pouch near the esophagogastric junction and excludes the major curvature, thus isolating the fundus — the richest source of ghrelin production3 — from direct contact with food. We hypothesized that circulating ghrelin concentrations in patients undergoing . . .