Pouch Emptying of Solid Foods after Gastroplasty for Morbid Obesity

Abstract

To obtain information on possible determinants of weight loss after horizontal gastroplasty, pouch emptying was prospectively investigated in 27 morbidly obese patients. A scintigraphic method was used. Examinations were carried out every 6 months until 2 years after surgery. Pouch emptying was described by means of delay, time until half emptying, mean transit time, and emptying rate. The measures all showed a significant (p less than 0.05) acceleration of pouch emptying during the first 6 months after gastroplasty. Thereafter pouch emptying was unaltered. No significant association could be detected between measures of pouch emptying and weight loss. From calculation of 95% confidence intervals for coefficients of correlation it proved very unlikely that pouch emptying is an important determinant of weight loss.

Risk of Gastric Pouch Enlargement With Adjustable Gastric Banding in Premenopausal Women

“…Gastric emptying studies performed on patients following stomach stapling procedures during the 1980s clearly demonstrated a lack of temporal relationship between the delay of food in the distal stomach and the prolonged satiety experienced after a meal with subsequent weight loss. [3][4][5][6] These findings were confirmed for VBG and the SG precursor-the Magenstrasse and Mill gastroplasty. 7,8 This finding has also been confirmed with LAGB where gastric emptying is normal, [9][10][11][12] but delay more than 2 to 3 minutes above the band is problematic.…”

Weight Loss After Laparoscopic Adjustable Gastric Banding is not Caused by Altered Gastric Emptying

“…However, others reported early satiety and weight loss after gastroplasty but did not find a significant retention in the gastric pouch or a decreased gastric emptying rate [6][7][8]. Further evidence for the existence of a relation between early satiety, weight loss, and a change in gastric emptying rate was found in patients with functional dyspepsia [9] and in an experiment in which glucagon-likepeptide was administered to obese subjects [10].…”

Failure of Preoperative Resting Energy Expenditure in Predicting Weight Loss after Gastroplasty

“…To our knowledge, this is the first prospective study investigating the predictive efficacy of preoperative energy expenditure on weight loss after VBG. To obviate any possible confounding effect caused by the proximal pouch size or to the outlet circumference (10, 11, 12), all patients in this series underwent a standard operation, in accordance with the gastric restriction technique widely reputed to give the best results (13). The fact that in this study a higher BW corresponded to a greater 1‐year weight loss is not surprising: the positive relationship between preoperative BW and REE values indicates that the patients with a high degree of obesity have an energy expenditure that is greater than that of their counterparts with lower BW.…”