Transcutaneous electrogastrography in the perioperative period in patients undergoing laparoscopic cholecystectomy and laparoscopic non-adjustable gastric banding.
BACKGROUND
Transcutaneous electrogastrography (EGG) is a non-invasive method of examination that allows monitoring of gastric myoelectric activity. The goal of this prospective study was to describe changes in gastric motility in the early postoperative period in extremely obese patients, who underwent planned surgery--Laparoscopic Non-Adjustable Gastric Banding (LNGB) and to establish the specificity of observed differences for this intervention.


METHODS
Myoelectric gastric activity was evaluated in the perioperative period in 20 extremely obese patients undergoing LNGB. The results of monitoring up to +24 h after the intervention were compared to a group of 15 healthy volunteers, and to a group of 20 patients undergoing laparoscopic cholecystectomy (LC). The recording was performed in both the patient and control groups 24 h before the operation and +5 h, +24 h and +48 h after the surgery, both in the fasting state and after stimulation with a liquid bolus. The data were recorded using the Microdigitrapper device and analyzed using the spectral analysis and Fourier transformation.


RESULTS
The finding characteristic in the early postoperative period was a decrease in frequency of both spontaneous and stimulated gastric contractions (bradygastria) at +5 h after the intervention, that was followed by rapid return to baseline activity. In patients after LNGB, the normalization of motility was seen within 24 h, and in patients after LC within 48 h after the intervention. Tachygastria was not found in any patient who did not have complications, but on the contrary it was found in both patients with significant dyspepsia after LC.


CONCLUSIONS
In the early postoperative period after LNGB, significant changes in myoelectric gastric activity were seen and were characterized by transient bradygastria. Comparison with the reference group of patients after LC shows that the intensity and duration of basal and stimulated bradygastria has a non-specific relationship with the extent of tissue trauma caused by the intraabdominal surgery. It is not specific for the gastric banding itself. The method of measuring the basal stimulated EGG potentials can be used in routine surgical practice as an auxiliary method for evaluation of the functional status of the gastrointestinal tract after intraabdominal surgery.
Gürlich
Robert
R
Institute of Pathological Physiology, 1st Medical Faculty, Charles University, Prague, Czech Republic. robert.gurlich@lf1.cuni.cz
Maruna
Pavel
P
Frasko
Roman
R
D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D004576:Electromyography / Q000379:methods*; D005260:Female; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D009767:Obesity, Morbid / Q000601:surgery; D011184:Postoperative Period; D011446:Prospective Studies; D013270:Stomach / Q000503:physiopathology*