4.1 Article

Comparative assessment of gastric emptying in obese patients before and after laparoscopic sleeve gastrectomy using radionuclide scintigraphy

Journal

NUCLEAR MEDICINE COMMUNICATIONS
Volume 36, Issue 8, Pages 854-862

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MNM.0000000000000337

Keywords

gastric emptying; laparoscopic sleeve gastrectomy; obesity; radionuclide scintigraphy

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Radionuclide scintigraphy provides a standard physiologic evaluation of gastric emptying (GE) after laparoscopic sleeve gastrectomy (LSG). This operation can be associated with motor gastric dysfunction and abnormal GE. The aim of this study was to evaluate the short-term effect of LSG on GE quantitative indices for liquids and solids compared with preoperative results. Forty obese patients were divided into two equal groups, the liquid and solid groups. Tc-99m-sulfur colloid GE scintigraphy was performed on all patients submitted to LSG before and after surgery (1-4 weeks for liquids and 4-6 weeks for solids). The quantitative indices included half emptying time (T-1/2) and percentage gastric retention at 15, 30, and 60min for liquids and at 30, 60, 90, and 120min for solids. A modified technique was used to label a boiled egg in order to be tolerated by the patients. T-1/2 was significantly enhanced after LSG compared with baseline (25.3 +/- 4.4 vs. 11.8 +/- 3.0min for liquids and 74.9 +/- 7.1 vs. 28.4 +/- 8.3min for solids, respectively, P<0.001). The percentage of gastric retention in operated patients was significantly less than that at baseline for liquids at 15, 30, and 60min (33.9 +/- 5.6, 17.7 +/- 3.9, and 7.5 +/- 2.8% vs. 69.4 +/- 10.5, 55.6 +/- 14.95, and 26.1 +/- 4.7%, respectively, P<0.001), as well as for solids at 30, 60, 90, and 120min (42.0 +/- 11.1, 20.8 +/- 6.1, 11.0 +/- 5.9, and 3.8 +/- 2.7% vs. 79.9 +/- 8.7, 67.4 +/- 12.2, 37.0 +/- 10.9%, and 13.8 +/- 4.4%, respectively, P<0.001). The significant acceleration of GE of liquids and solids after LSG may have contributed to weight loss in the immediate postoperative period (4-6 weeks). It remains to be determined whether the weight loss will continue beyond that period.

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