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Obesity Surgery
Published in: Obesity Surgery 7/2020

01-07-2020 | Obesity | Original Contributions

Acceleration of Gastric Emptying and Improvement of GERD Outcome After Laparoscopic Sleeve Gastrectomy in Non-diabetic Obese Patients

Authors: Mohamed Abdalla Salman, Hani Maurice Sabri Mikhail, Ahmed Abdelsalam, Ahmed Abdallah, Hossam E. Elshafey, Tarek Elsayed Abouelregal, Mahmoud Gouda Omar, Hesham Elkassar, Reham Abdelghany Ahmed, Mohamed Atallah, Hossam El-Din Shaaban, Zeinab Abdellatif, Shaimaa Elkholy, Ahmed Abdallah Salman

Published in: Obesity Surgery | Issue 7/2020

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Abstract

Purpose

Obesity has become a pandemic nowadays. Bariatric surgery is increasingly performed to manage obesity. Currently, laparoscopic sleeve gastrectomy (LSG) is a widely accepted procedure given its feasibility and efficacy. Previous studies revealed conflicting results regarding the change of gastric emptying following sleeve gastrectomy. The primary aim of the present study is to assess gastric motor function by gastric emptying scintigraphy in a cohort of non-diabetic patients undergoing laparoscopic sleeve gastrectomy (LSG) for treatment of severe obesity.

Methods

This prospective observational study included 100 obese, non-diabetic patients attending the surgery clinic at Cairo University Hospitals and Al Azhar University Hospitals. LSG was performed following a standardized protocol, with no complications observed. All patients had gastric emptying scintigraphy done through a standard semisolid meal (250 kcal), marked with 0.5 mCiTc 99, pre-operatively and 3 months after LSG.

Results

The mean age was 38.71 years (9.2) and males comprised 57% of the cohort. The body mass index, low-density lipoproteins, and glycated hemoglobin declined significantly at 3-month postsurgery. The scintigraphy study revealed a significantly reduced percent retention at equivalent time points 3 months after LSG. In addition, the percent of patients suffering from GERD decreased significantly after LSG.

Conclusion

Gastric emptying becomes faster after LSG in morbidly obese non-diabetic patients. GERD symptoms improve after surgery.
Literature
1.
Angrisani L, Santonicola A, Lovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27(9):2279–89.CrossRef
2.
Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15(8):1124–8.CrossRef
3.
Langer FB, Hoda MAR, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.CrossRef
4.
Inui A, Asakawa A, Bowers CY, et al. Ghrelin, appetite, and gastric motility: the emerging role of the stomach as an endocrine organ. FASEB J. 2004;18(3):439–56.CrossRef
5.
Janssen P, Berghe PV, Verschueren S, et al. Review article: the role of gastric motility in the control of food intake. Aliment Pharmacol Ther. 2011;33(8):880–94.CrossRef
6.
Sioka E, Tzovaras G, Perivoliotis K, et al. Impact of laparoscopic sleeve gastrectomy on gastrointestinal motility. Gastroenterol Res Pract. 2018;2018:4135813.CrossRef
7.
Pilone V, Tramontano S, Di Micco R, et al. Gastric emptying after sleeve gastrectomy: statistical evidence of a controlled prospective study with gastric scintigraphy. Minerva Chir. 2013;68(4):385–92.PubMed
8.
Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy—a restrictive procedure? Obes Surg. 2007;17:57–62.CrossRef
9.
Vives M, Molina A, Danús M, et al. Analysis of gastric physiology after laparoscopic sleeve gastrectomy (LSG) with or without antral preservation in relation to metabolic response: a randomised study. Obes Surg. 2017;27(11):2836–44.CrossRef
10.
Griffith GH, Owen GM, Kirkman S, et al. Measurement of the rate of gastric emptying using chromium-51. Lancet. 1966;1:1244–5.CrossRef
11.
American Diabetes Association. Standards of medical care in diabetes 2011. Diabetes Care. 2011;34:S11.CrossRef
12.
Allen CJ, Parameswaran K, Belda J, et al. Reproducibility, validity, and responsiveness of a disease-specific symptom questionnaire for gastroesophageal reflux disease. Dis Esophagus. 2000;13(4):265–70.CrossRef
13.
Yehoshua RT, Eidelman AL, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18:1083–8.CrossRef
14.
Bernstine H, Tzioni-Yehoshua R, Groshar D, et al. Gastric emptying is not affected by sleeve gastrectomy--scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg. 2009;19(3):293–8.CrossRef
15.
Kandeel AA, Sarhan MD, Hegazy T, et al. Comparative assessment of gastric emptying in obese patients before and after laparoscopic sleeve gastrectomy using radionuclide scintigraphy. Nucl Med Commun. 2015;36(8):854–62.CrossRef
16.
Pomerri F, Foletto M, Allegro G, et al. Laparoscopic sleeve gastrectomy--radiological assessment of fundus size and sleeve voiding. Obes Surg. 2011;21(7):858–63.CrossRef
17.
Parikh M, Eisner J, Hindman N, et al. Tests of correlation between immediate postoperative gastroduodenal transit times and weight loss after laparoscopic sleeve gastrectomy. Surg Endosc. 2012;26(12):3548–51.CrossRef
18.
Hayat JO, Wan A. The effects of sleeve gastrectomy on gastroesophageal reflux and gastroesophageal motility. Expert Rev Gastroenterol Hepatol. 2014;8(4):445–52.CrossRef
19.
Mion F, Tolone S, Garros A, et al. High-resolution impedance manometry after sleeve gastrectomy: increased intragastric pressure and reflux are frequent events. Obes Surg. 2016;26:2449–56.CrossRef
20.
Daher HB, Sharara AI. Gastroesophageal reflux disease, obesity and laparoscopic sleeve gastrectomy: the burning questions. World J Gastroenterol. 2019;25(33):4805–13.CrossRef
21.
Braghetto I, Csendes A, Korn O, et al. Gastroesophageal reflux disease after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(3):148–53.CrossRef
22.
Moon HS, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRef
23.
Gibson SC, Le Page PA, Taylor CJ. Laparoscopic sleeve gastrectomy: review of 500 cases in single surgeon Australian practice. ANZ J Surg. 2015;85:673–7.CrossRef
24.
DuPree CE, Blair K, Steele SR, et al. Laparoscopic sleeve gastrectomy in patients with preexisting gastroesophageal reflux disease: a national analysis. JAMA Surg. 2014;149:328–34.CrossRef
25.
Sheppard CE, Sadowski DC, de Gara CJ, et al. Rates of reflux before and after laparoscopic sleeve gastrectomy for severe obesity. Obes Surg. 2015;25:763–8.CrossRef
26.
Howard DD, Caban AM, Cendan JC, et al. Gastroesophageal reflux after sleeve gastrectomy in morbidly obese patients. Surg Obes Relat Dis. 2011;7:709–13.CrossRef
27.
Lazoura O, Zacharoulis D, Triantafyllidis G, et al. Symptoms of gastroesophageal reflux following laparoscopic sleeve gastrectomy are related to the final shape of the sleeve as depicted by radiology. Obes Surg. 2010;21(3):295–9.CrossRef
28.
Soricelli E, Casella G, Rizzello M, et al. Initial experience with laparoscopic crural closure in the management of hiatal hernia in obese patients undergoing sleeve gastrectomy. Obes Surg. 2010;20(8):1149–53.CrossRef
29.
Keidar A, Appelbaum L, Schweiger C, et al. Dilated upper sleeve can be associated with severe postoperative gastroesophageal dysmotility and reflux. Obes Surg. 2010;20(2):140–7.CrossRef
30.
Daes J, Jimenez ME, Said N, et al. Laparoscopic sleeve gastrectomy: symptoms of gastroesophageal reflux can be reduced by changes in surgical technique. Obes Surg. 2012;22(12):1874–9.CrossRef
Metadata
Title
Acceleration of Gastric Emptying and Improvement of GERD Outcome After Laparoscopic Sleeve Gastrectomy in Non-diabetic Obese Patients
Authors
Mohamed Abdalla Salman
Hani Maurice Sabri Mikhail
Ahmed Abdelsalam
Ahmed Abdallah
Hossam E. Elshafey
Tarek Elsayed Abouelregal
Mahmoud Gouda Omar
Hesham Elkassar
Reham Abdelghany Ahmed
Mohamed Atallah
Hossam El-Din Shaaban
Zeinab Abdellatif
Shaimaa Elkholy
Ahmed Abdallah Salman
Publication date
01-07-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 7/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04547-8

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