Gastric emptying is not affected by sleeve gastrectomy--scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum.
BACKGROUND
The aim of this study is to clarify whether laparoscopic sleeve gastrectomy (LSG) to treat morbid obesity causes changes in gastric emptying.


METHODS
Gastric emptying scintigraphy was performed before and 3 months after LSG, in 21 consecutive morbidly obese patients. After an overnight fast, subjects consumed a standard semi-solid meal, to which 0.5 mCi Tc99-labeled sulfur colloid had been added. The meal was consumed within 10 min. Scintigraphic imaging was performed with a gamma camera immediately after the completion of the meal as well as after 30, 60, 120, 180, and 240 min. Quantitative and qualitative analysis was performed by drawing a region of interest (ROI) enclosing the stomach on the anterior and the posterior images. Time 0 was considered the time of meal completion (all the ingested activity) and was defined as 100% retention. The same ROI was used on all consecutive images of the same projection for the same patient. The geometric mean of the anterior and the posterior counts for each time point is calculated and corrected for Tc(99m) decay. Gastric emptying curves were constructed. T 1/2 is the time interval between completion of the meal and the point at which half of the meal (by radioactivity counts) has left the stomach. Retention is expressed as the percent remaining in the stomach at each time point (half, 1, 2, 3, 4 h).


RESULTS
The mean T 1/2 raw data was 62.39+/-19.83 and 56.79+/-18.72 min (p=0.36, t=-0.92, NS) before and 3 months after LSG, respectively. The T 1/2 linear was 103.64+/-9.82 and 106.92+/-14.55, (p=0.43, t=-0.43, NS), and the linear fit slope 0.48+/-0.04 and 0.47+/-0.05 (p=0.48, t=0.7, NS).


CONCLUSIONS
LSG with antrum preservation as performed in this series has no effect on gastric emptying.
Bernstine
Hanna
H
Department of Nuclear Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Tzioni-Yehoshua
Ronit
R
Groshar
David
D
Beglaibter
Nahum
N
Shikora
Scott
S
Rosenthal
Raul J
RJ
Rubin
Moshe
M
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D011446:Prospective Studies; D011706:Pyloric Antrum; D011877:Radionuclide Imaging; D016896:Treatment Outcome; D055815:Young Adult