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Obesity Surgery
Published in: Obesity Surgery 5/2011

01-05-2011 | Physiology Research

Gastric Emptying and Postprandial PYY Response After Biliopancreatic Diversion with Duodenal Switch

Authors: Jakob Hedberg, Hans Hedenström, F. Anders Karlsson, Britt Edén-Engström, Magnus Sundbom

Published in: Obesity Surgery | Issue 5/2011

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Abstract

Background

Super-obesity (BMI > 50) is increasing rapidly. We use the biliopancreatic diversion with duodenal switch (BPD-DS) as one option in this patient category. The aim of the present study was to investigate the emptying of the gastric tube, PYY levels and dumping symptoms after BPD-DS.

Methods

Emptying of the gastric tube was investigated with scintigraphy after an overnight fast. Twenty patients (median age 43 years, BMI 31.1 kg/m2) having undergone BPD-DS in median 3.5 years previously were included in the scintigraphic study. A technetium-labelled omelette was ingested and scintigraphic evaluation of gastric emptying was undertaken. Ten of the patients also underwent PYY measurements after a standardised meal and were compared to nine non-operated age-matched normal weight controls, both in the fasting state and after the test meal. Frequency of dumping symptoms was evaluated in all patients.

Results

The half-emptying time was 28 ± 16 min. Lag phase was present in 30% of the patients. PYY levels were significantly higher in BPD-DS patients as compared to controls both in the fasting state (p < 0.001) and after the test meal (p < 0.001). Dumping symptoms were scarce and occurred in 17 of the 20 patients only few times yearly or less.

Conclusions

Although the pylorus is preserved in BPD-DS, the stomach emptying is faster than in non-operated subjects. PYY levels are elevated in the fasting state after BPD-DS and a marked response to a test meal is seen, likely due to the rapid stimulation of intraluminal nutrients in the distal ileum. In spite of this, dumping symptoms are uncommon.
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Metadata
Title
Gastric Emptying and Postprandial PYY Response After Biliopancreatic Diversion with Duodenal Switch
Authors
Jakob Hedberg
Hans Hedenström
F. Anders Karlsson
Britt Edén-Engström
Magnus Sundbom
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 5/2011
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-010-0288-7

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