期刊
OBESITY SURGERY
卷 21, 期 2, 页码 217-223出版社
SPRINGER
DOI: 10.1007/s11695-010-0312-y
关键词
Obesity; Gastric emptying; Esophageal transit; Weight loss; Satiety; Satiation; Bariatric; Surgery; Adjustable gastric band; Restrictive
类别
资金
- Allergan Inc.
- National Health and Medical Research Council
- Royal Australasian College of Surgeons
Laparoscopic adjustable gastric banding (LAGB) induces and sustains weight loss, likely by activating the peripheral satiety mechanism. Recent data suggests that food is not retained above the optimally adjusted LAGB, suggesting that an alternate mechanism is inducing satiety. How transit and gastric emptying change following LAGB and correlate with satiety and weight loss have not been adequately defined. LAGB patients underwent preoperative and 12-month follow-up nuclear scintigraphic assessments of esophageal transit and gastric emptying. A new technique that allowed the calculation of emptying times and transit through the supra- and infraband compartments was used to assess emptying and transit patterns postoperatively. Postoperatively, patients reported increased satiety both after a standard fast (3.7 +/- 2.3 vs. 4.8 +/- 2.1, p = 0.04) and following a standard semisolid meal (5.9 vs. 7.8 +/- 1.7, p = 0.003). The mean percent excess weight loss was 48.5 +/- 23.2%. The gastric emptying half-time (minutes) did not change significantly (63.5 +/- 41.1 vs. 73.3 +/- 26.8, p = 0.64). Semisolid transit into the infraband stomach was delayed briefly postoperatively in more patients (11 vs. 2, p = 0.001). There was minimal retention of the meal above the LAGB 2 min after commencing the gastric emptying study (median, 3%; interquartile range, 1.75-10); therefore, an emptying half-time of the supraband region could not be defined. Weight loss, satiety, and early satiation following LAGB were associated with briefly delayed bolus transit into the infraband stomach. Retention of the semisolid meal above the LAGB was not observed. This is further evidence that suggests satiety develops following LAGB without physical restriction of meal size.
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