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Gastric Emptying is not Affected by Sleeve Gastrectomy—Scintigraphic Evaluation of Gastric Emptying after Sleeve Gastrectomy without Removal of the Gastric Antrum

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Abstract

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 Tc99m 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.

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Authors and Affiliations

  1. Felsenstein Medical Research Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Ronit Tzioni-Yehoshua & Moshe Rubin

  2. Department of Nuclear Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Hanna Bernstine & David Groshar

  3. Department of Surgery, Beilinson Campus, Petah Tikva, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Moshe Rubin

  4. Department of Surgery, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel

    Nahum Beglaibter

  5. Tufts Medical Center, Boston, MA, USA

    Scott Shikora

  6. Cleveland Clinic Florida, Weston, FL, USA

    Raul J. Rosenthal

  7. Department of Surgery “B”, Beilinson Medical Center, Petah Tikva, 49100, Israel

    Moshe Rubin

Authors
  1. Hanna Bernstine
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  2. Ronit Tzioni-Yehoshua
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  3. David Groshar
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  4. Nahum Beglaibter
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  5. Scott Shikora
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  6. Raul J. Rosenthal
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  7. Moshe Rubin
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Corresponding author

Correspondence to Moshe Rubin.

Additional information

This work was performed in partial fulfillment of the requirements for a MSc degree of Ronit Tzioni Yehoshua, Sackler Faculty of Medicine, Tel Aviv University, Israel.

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Bernstine, H., Tzioni-Yehoshua, R., Groshar, D. et al. Gastric Emptying is not Affected by Sleeve Gastrectomy—Scintigraphic Evaluation of Gastric Emptying after Sleeve Gastrectomy without Removal of the Gastric Antrum. OBES SURG 19, 293–298 (2009). https://doi.org/10.1007/s11695-008-9791-5

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  • DOI: https://doi.org/10.1007/s11695-008-9791-5

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