Po-Jen Yang1,2, Mei-Fang Cheng3, Wei-Shiung Yang2,4,5, Ming-Shian Tsai6,7, Po-Chu Lee1,2, Chiung-Nien Chen1,2, Ming-Tsan Lin1, Ping-Huei Tseng8,9. 1. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. 2. Center for Obesity, Life Style, and Metabolic Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. 3. Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan. 4. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. 5. Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. 6. Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan. 7. School of Medicine, I-Shou University, Kaohsiung, Taiwan. 8. Center for Obesity, Life Style, and Metabolic Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. pinghuei@ntu.edu.tw. 9. Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. pinghuei@ntu.edu.tw.
Abstract
BACKGROUND: Recent reports have shown that sleeve gastrectomy (SG) accelerates gastric emptying (GE), but the etiology remains unclear. This study aimed to investigate the factors affecting GE before and after SG. METHODS: We enrolled 35 normal weight healthy subjects and 23 obese patients receiving SG. The normal individuals and obese patients before and 3 months after SG received oatmeal-based scintigraphy to measure GE. Gastrointestinal symptoms and circulating levels of peptide YY (PYY) were also measured. RESULTS: There were no differences in the GE parameters, including simple half-time at 3 h and percentage of gastric retention at 0.5, 1, 2, and 3 h between healthy controls and pre-SG obese subjects. SG led to accelerated GE, more gastrointestinal symptoms, and increased fasting PYY levels postoperatively. Based on our previously established normal GE values, 18 (78.3%) obese patients with rapid postoperative GE had higher levels of preoperative fasting glucose and glycated hemoglobin, and homeostasis model assessment of the insulin resistance index than those with normal postoperative GE. Twelve (52.2%) obese patients had preoperative diabetes mellitus (DM), and only four (17.4%) remained diabetic after SG. The post-SG gastric retention at 0.5 and 1 h was lower in patients with preoperative DM than in those without preoperative DM. Neither severity of gastrointestinal symptoms nor fasting PYY levels were associated with postoperative GE alterations. CONCLUSION: Most of the obese patients had accelerated GE after SG. A higher preoperative glycemic profile was associated with rapid post-SG GE.
BACKGROUND: Recent reports have shown that sleeve gastrectomy (SG) accelerates gastric emptying (GE), but the etiology remains unclear. This study aimed to investigate the factors affecting GE before and after SG. METHODS: We enrolled 35 normal weight healthy subjects and 23 obesepatients receiving SG. The normal individuals and obesepatients before and 3 months after SG received oatmeal-based scintigraphy to measure GE. Gastrointestinal symptoms and circulating levels of peptide YY (PYY) were also measured. RESULTS: There were no differences in the GE parameters, including simple half-time at 3 h and percentage of gastric retention at 0.5, 1, 2, and 3 h between healthy controls and pre-SG obese subjects. SG led to accelerated GE, more gastrointestinal symptoms, and increased fasting PYY levels postoperatively. Based on our previously established normal GE values, 18 (78.3%) obesepatients with rapid postoperative GE had higher levels of preoperative fasting glucose and glycated hemoglobin, and homeostasis model assessment of the insulin resistance index than those with normal postoperative GE. Twelve (52.2%) obesepatients had preoperative diabetes mellitus (DM), and only four (17.4%) remained diabetic after SG. The post-SG gastric retention at 0.5 and 1 h was lower in patients with preoperative DM than in those without preoperative DM. Neither severity of gastrointestinal symptoms nor fasting PYY levels were associated with postoperative GE alterations. CONCLUSION: Most of the obesepatients had accelerated GE after SG. A higher preoperative glycemic profile was associated with rapid post-SG GE.
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