title: Gastric emptying after sleeve gastrectomy: statistical evidence of a controlled prospective study with gastric scintigraphy.
abstract: OBJECTIVE
  Laparoscopic sleeve gastrectomy (LSG) is a stand-alone bariatric procedure, its feasibility and efficacy being confirmed by long-term data. The effect of the procedure is believed to be based on the gastric restriction and reduction of ghrelin. Nevertheless it remains still controversial the role of LSG on gastric emptying and the impact that this may have on weight loss outcomes. Our aim is to assess gastric emptying after LSG using gastric scintigraphy.
  
  
  METHODS
  For this prospective randomized study, 45 patients undergoing LSG at our Centre for the Multidisciplinary Treatment of Severe Obesity from April 2009 to April 2011 were enrolled and observed prospectively (Group A). The inclusion criteria followed the guidelines for bariatric surgery. All patients performed gastric emptying scintigraphy through a standard semisolid meal (250 kcal), marked with 0.5 mCiTc 99. Group A performed the exam before (A1) and after the operation (A2). A control group (Group B) included 20 patients undergoing scintigraphic assessment for other reasons.
  
  
  RESULTS
  LSG was performed following a standardized technique. No complications were observed. The scintigraphic study showed a reduced half-life tracer (A1 vs. A2: 80.4±16.5 min vs. 64.3±22 min P=0.06), without a significant difference. Comparing the two groups no differences occurred before operation (B vs. A1). Gastric emptying time resulted significatively reduced in group A2 rather than in group A1 and B.
  
  
  CONCLUSIONS
  Gastric motility plays a role in the pathogenesis of obesity. Our experience suggests that LSG reduces gastric emptying time, but further studies are necessary to reach statystical significativity.
authors.affiliation: Department of Medicine and Surgery University of Salerno, Salerno, Italy - ariolahasani@libero.it.
authors.forename: V
authors.initials: V
authors.lastname: Pilone
authors.forename: S
authors.initials: S
authors.lastname: Tramontano
authors.forename: R
authors.initials: R
authors.lastname: Di Micco
authors.forename: A
authors.initials: A
authors.lastname: Monda
authors.forename: A
authors.initials: A
authors.lastname: Hasani
authors.forename: G
authors.initials: G
authors.lastname: Izzo
authors.forename: A
authors.initials: A
authors.lastname: Vitiello
authors.forename: M G
authors.initials: MG
authors.lastname: Caprio
authors.forename: A
authors.initials: A
authors.lastname: Cuocolo
authors.forename: P
authors.initials: P
authors.lastname: Forestieri
mesh_terms: D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying; D006801:Humans; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013270:Stomach / Q000000981:diagnostic imaging* / Q000502:physiology*