M Vives1, A Molina1, M Danús2, E Rebenaque3, S Blanco1, M París1, A Sánchez1, F Sabench4, D Del Castillo5. 1. Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain. 2. Nuclear Medicine Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain. 3. Radiology Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain. 4. Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain. fsabench@gmail.com. 5. Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain. ddelcastillo@grupsagessa.cat.
Abstract
INTRODUCTION:Laparoscopic sleeve gastrectomy is one of the most common techniques in bariatric surgery, but there is no consensus on the optimal distance from the pylorus to start the gastric transection. The aim of this study is to determine the differences in gastric emptying, gastric distension and metabolic response between two starting distances. MATERIAL AND METHODS: This is a prospective randomised study of 60 patients (30 patients with the section at 3 cm and 30 patients at 8 cm from the pylorus). We calculate at 6 and 12 months from surgery gastric emptying by scintigraphy (T1/2 min), gastric volume by CT scan (cc) and metabolic response by blood sample analysis (glucose, HbA1c, insulin, HOMA-IR, GLP-1, GIP and C-peptide). RESULTS:Gastric emptying increases the speed significantly in both groups but is greater in the 3-cm group (p < 0.05). Dividing groups into type 2 diabetic patients and non-diabetic patients, the speed in non-diabetic patients is significantly higher for the 3-cm group. Residual volume increases significantly in both groups, and there are no differences between them. One year after surgery, there are significant improvements in the hyperinsulinaemia in the patients of the 3-cm group with respect to the 8-cm group, but only in diabetic patients. No differences between groups are found regarding changes in GLP-1 or GIP. CONCLUSIONS:Gastric emptying is faster in patients with antrum resection. The distance does not influence the gastric emptying of diabetic patients. Other mechanisms may explain metabolic response besides GLP-1 and its association with improvements in diabetes via gastric emptying.
RCT Entities:
INTRODUCTION: Laparoscopic sleeve gastrectomy is one of the most common techniques in bariatric surgery, but there is no consensus on the optimal distance from the pylorus to start the gastric transection. The aim of this study is to determine the differences in gastric emptying, gastric distension and metabolic response between two starting distances. MATERIAL AND METHODS: This is a prospective randomised study of 60 patients (30 patients with the section at 3 cm and 30 patients at 8 cm from the pylorus). We calculate at 6 and 12 months from surgery gastric emptying by scintigraphy (T1/2 min), gastric volume by CT scan (cc) and metabolic response by blood sample analysis (glucose, HbA1c, insulin, HOMA-IR, GLP-1, GIP and C-peptide). RESULTS: Gastric emptying increases the speed significantly in both groups but is greater in the 3-cm group (p < 0.05). Dividing groups into type 2 diabeticpatients and non-diabeticpatients, the speed in non-diabeticpatients is significantly higher for the 3-cm group. Residual volume increases significantly in both groups, and there are no differences between them. One year after surgery, there are significant improvements in the hyperinsulinaemia in the patients of the 3-cm group with respect to the 8-cm group, but only in diabeticpatients. No differences between groups are found regarding changes in GLP-1 or GIP. CONCLUSIONS: Gastric emptying is faster in patients with antrum resection. The distance does not influence the gastric emptying of diabeticpatients. Other mechanisms may explain metabolic response besides GLP-1 and its association with improvements in diabetes via gastric emptying.
Authors: E Segura Molina; A J Chover González; F Partida Palma; J M Freire Macías; A García Curiel; A Ortega Alvaro; M Gómez Molinero; L Escobar Jiménez Journal: Rev Esp Med Nucl Date: 2006 May-Jun
Authors: Adam M Deane; Nam Q Nguyen; Julie E Stevens; Robert J L Fraser; Richard H Holloway; Laura K Besanko; Carly Burgstad; Karen L Jones; Marianne J Chapman; Chris K Rayner; Michael Horowitz Journal: J Clin Endocrinol Metab Date: 2009-11-05 Impact factor: 5.958
Authors: Pablo Vidal; José Manuel Ramón; Marcos Busto; Gerardo Domínguez-Vega; Albert Goday; Manuel Pera; Luis Grande Journal: Obes Surg Date: 2014-03 Impact factor: 4.129
Authors: Andrés Hanssen; Sergio Plotnikov; Geylor Acosta; José Tomas Nuñez; José Haddad; Carmen Rodriguez; Claudia Petrucci; Diego Hanssen; Rafael Hanssen Journal: Obes Surg Date: 2018-03 Impact factor: 4.129
Authors: Eric J Vargas; Fateh Bazerbachi; Gerardo Calderon; Larry J Prokop; Victoria Gomez; M Hassan Murad; Andres Acosta; Michael Camilleri; Barham K Abu Dayyeh Journal: Clin Gastroenterol Hepatol Date: 2019-04-04 Impact factor: 11.382
Authors: Anna Hernández-Aguilera; Núria Casacuberta; Helena Castañé; Montserrat Fibla; Salvador Fernández-Arroyo; Isabel Fort-Gallifa; Marta París; Fàtima Sabench; Daniel Del Castillo; Gerard Baiges-Gaya; Elisabet Rodríguez-Tomàs; Teresa Sans; Jordi Camps; Jorge Joven Journal: Biol Trace Elem Res Date: 2021-02-08 Impact factor: 3.738