title: Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  Dumping syndrome is a well-known complication after upper gastrointestinal (GI) surgery. There are scarce data in the literature about the incidence of dumping after bariatric operations but, certainly no relation between this syndrome and laparoscopic sleeve gastrectomy (LSG) has been attempted.
  
  
  METHODS
  We conducted a prospective clinical study in order to evaluate the potential presence, incidence and severity of Dumping syndrome after LSG. Thirty one non-diabetic morbidly obese patients (eight male, 23 female) eligible for LSG were evaluated. Median age was 38 (22-58 years) and mean body mass index (BMI) was 45.55 (± 5.37). The diagnosis of dumping syndrome was based on clinical provocation of signs and symptoms using an oral glucose challenge before and 6 weeks after the operation. The Sigstad's dumping score was estimated in order to separate dumpers from non-dumpers, and the Arts questionnaire was completed to distinguish between early and late dumping. Moreover, blood glucose levels during the oral glucose challenge were measured.
  
  
  RESULTS
  No patient had symptoms of dumping after provocation preoperatively, whereas after LSG 9 patients (29%) experienced definite dumping and other 5 patients (16%) symptoms suggestive of dumping syndrome. Arts' questionnaire demonstrated that dumping occurrence after LSG was associated with early symptoms. Late hypoglycaemia occurred in one patient.
  
  
  CONCLUSIONS
  A significant proportion of patients after LSG experienced dumping syndrome upon provocation. It seems that LSG should no longer be considered as a pure restrictive procedure, and it might be an option for heavy sweeters by changing their food tolerance patterns.
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, Larissa 411 10, Greece. gtzovaras@hotmail.com
authors.forename: George
authors.initials: G
authors.lastname: Tzovaras
authors.forename: Dimitris
authors.initials: D
authors.lastname: Papamargaritis
authors.forename: Eleni
authors.initials: E
authors.lastname: Sioka
authors.forename: Eleni
authors.initials: E
authors.lastname: Zachari
authors.forename: Ioannis
authors.initials: I
authors.lastname: Baloyiannis
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zacharoulis
authors.forename: George
authors.initials: G
authors.lastname: Koukoulis
mesh_terms: D000328:Adult; D004377:Dumping Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods*; D005951:Glucose Tolerance Test; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult