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Radical Resection of the Pyloric Antrum and Its Effect on Gastric Emptying After Sleeve Gastrectomy

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Abstract

Background

The surgical technique of laparoscopic sleeve gastrectomy (LSG) has not been fully standardized yet and there is the unresolved question of what is the optimum size of retained pyloric antrum. The aim of our research was to prove that even after a radical resection of the pyloric antrum the physiological stomach evacuation function can still be preserved.

Methods

Our study was based on 12 patients, who were randomly divided into two groups. Patients undergoing radical antrum resection (RA group) underwent gastric emptying scintigraphy to determine the evacuation half-time (T1/2) and food retention in the 90th minute of the test (%GE) both before the operation and 3 months afterward. Patients in whom the antrum was preserved (PA group) served as a control group for comparison of postoperative weight loss (in kilogram), decrease in body mass index (BMI), and decline in excess weight (%EWL). The resulting changes were statistically processed.

Results

In the RA group, the average time T1/2 declined from 57.5 to 32.25 min (p = 0.016) and average retention %GE dropped from 20.5 to 9.5 % (p = 0.073). Differences in the average values of weight, BMI, or %EWL between both groups were of no statistical significance (p > 0.8).

Conclusions

In the RA group, an increase in gastric emptying postoperatively was noted. Complications such as failure of stomach evacuation were not observed in the RA group. Our results suggest that even more radical resection of the pyloric antrum performed by LSG is possible without concerns of postoperative disorder of the stomach evacuation function.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. First Surgical Department, General Faculty Hospital and First Faculty of Medicine, Charles University, U nemocnice 2, 128 08, Prague 2, Czech Republic

    David Michalsky

  2. Department of Nuclear Medicine, General Faculty Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic

    Petr Dvorak

  3. Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Prague, Czech Republic

    Jaromir Belacek

  4. Surgical Clinic, Central Military Hospital and Second Faculty of Medicine, Charles University, Prague, Czech Republic

    Mojmir Kasalicky

Authors
  1. David Michalsky
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  2. Petr Dvorak
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  4. Mojmir Kasalicky
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Correspondence to David Michalsky.

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Michalsky, D., Dvorak, P., Belacek, J. et al. Radical Resection of the Pyloric Antrum and Its Effect on Gastric Emptying After Sleeve Gastrectomy. OBES SURG 23, 567–573 (2013). https://doi.org/10.1007/s11695-012-0850-6

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  • DOI: https://doi.org/10.1007/s11695-012-0850-6

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