Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus

Shah, Shashank; Shah, Poonam; Todkar, Jayashree S.; Gautier, Michel; Sonar, Sameer; Solav, Shrikant

doi:10.1016/j.soard.2009.11.019

Cited by 140 publications

(87 citation statements)

References 22 publications

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“…Satiation (5) has been associated with fasting gastric volume, gastric emptying, and upper gastrointestinal motility (6). Although studies have suggested that SG accelerates gastric emptying (7)(8)(9), this is a controversial issue. Meanwhile, gallbladder motility in obese individuals is generally believed to be impaired, although few studies confirm this (10).…”

Section: Introductionmentioning

confidence: 99%

Sleeve gastrectomy effects on hunger, satiation, and gastrointestinal hormone and motility responses after a liquid meal test

Mans¹,

Serra‐Prat

Palomera³

et al. 2015

The American Journal of Clinical Nutrition

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Background: The relation between hunger, satiation, and integrated gastrointestinal motility and hormonal responses in morbidly obese patients after sleeve gastrectomy has not been determined. Objective: The objective was to assess the effects of sleeve gastrectomy on hunger, satiation, gastric and gallbladder motility, and gastrointestinal hormone response after a liquid meal test. Design: Three groups were studied: morbidly obese patients (n = 16), morbidly obese patients who had had sleeve gastrectomy (n = 8), and nonobese patients (n = 16). The participants fasted for 10 h and then consumed a 200-mL liquid meal (400 kcal + 1.5 g paracetamol).Fasting and postprandial hunger, satiation, hormone concentrations, and gastric and gallbladder emptying were measured several times over 4 h. Results: No differences were observed in hunger and satiation curves between morbidly obese and nonobese groups; however, sleeve gastrectomy patients were less hungry and more satiated than the other groups. Antrum area during fasting in morbidly obese patients was statistically significant larger than in the nonobese and sleeve gastrectomy groups. Gastric emptying was accelerated in the sleeve gastrectomy group compared with the other 2 groups (which had very similar results). Gallbladder emptying was similar in the 3 groups. Sleeve gastrectomy patients showed the lowest ghrelin concentrations and higher early postprandial cholecystokinin and glucagon-like peptide 1 peaks than did the other participants. This group also showed an improved insulin resistance pattern compared with morbidly obese patients. Conclusions: Sleeve gastrectomy seems to be associated with profound changes in gastrointestinal physiology that contribute to reducing hunger and increasing sensations of satiation. These changes include accelerated gastric emptying, enhanced postprandial cholecystokinin and glucagon-like peptide 1 concentrations, and reduced ghrelin release, which together may help patients lose weight and improve their glucose metabolism after surgery. This trial was registered at clinicaltrials.gov as NCT02414893.Am J Clin Nutr 2015;102:540-7.

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Section: Introductionmentioning

confidence: 99%

Sleeve gastrectomy effects on hunger, satiation, and gastrointestinal hormone and motility responses after a liquid meal test

Mans¹,

Serra‐Prat

Palomera³

et al. 2015

The American Journal of Clinical Nutrition

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“…Its discovery has shed new light on many physiological functions. Among the several actions of this peptide in the human body, ranging from its involvement in the regulation of the immune and cardiovascular systems to the up-regulation of insulin-like growth factor, it has a dominant role in the gastrointestinal system, with involvement in gastric emptying and intestinal motility (10)(11)(12)(13)(14).…”

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confidence: 99%

Ghrelin and Obesity: Identifying Gaps and Dispelling Myths. A Reappraisal

Makris

Alexandrou

Papatsoutsos

et al. 2017

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Abstract. The etiology of obesity is complex. Environmental and genetic causes have been implicated in the development of this disease. Ghrelin is a hormoneObesity is a major public health problem as more than 10% of the global population is obese (1). The number of patients affected by this modern epidemic and the associated comorbidities, such as diabetes mellitus, cardiovascular diseases and cancer, are constantly rising, along with the associated health costs, making the management of obesity one of paramount importance (2, 3).There are mainly two ways to manage obesity: the conservative one (e.g. diet, exercise and lifestyle changes) and the surgical approach through various weight-loss surgical procedures, widely known as bariatric surgery.Surgery not only leads to malabsorption (calories are not taken up by the intestine), mechanical restriction (less room for food), but also to hormonal changes that lead to less hunger or earlier satiety postprandially (3, 4).During the past couple of decades the identification of circulating factors that contribute to the induction of hunger (orexigenic) or satiety (anorexigenic) has diversified the cause of food restriction after bariatric surgery apart from being solely a mechanical phenomenon to a more complex effect of both anatomical and humoral modifications induced by the different operative strategies.Ghrelin is a well-known orexigenic hormone that stimulates food intake in a dose-dependent manner (5-8). Ghrelin increases appetite both by initiating homeostatic feeding driven by metabolic need and by non-homeostatic feeding, acting centrally and affecting the modulation of reward, memory and motivated feeding behavior (9).In this review, we planned to highlight the available data regarding the appetite-generating effect of ghrelin. We searched the literature in order to find determinants with a proven direct positive feedback in appetite.

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“…Braghetto et al 8 confirmed this in their subsequent study, showing acceleration for liquids and solids (78 -38 min). Shah et al 9 showed acceleration of gastric emptying time and small bowel transit time by at least 25 % in diabetic patients undergoing LSG. However, a study by Bernstine et al 10 which measured gastric emptying in patients before and 3 months after LSG showed no effect on gastric emptying.…”

Section: Discussionmentioning

confidence: 96%

Gastric Emptying Time after Laparoscopic Sleeve Gastrectomy

Singh¹,

Aggarwal²

2018

Int. J. Curr. Res. Biol. Med.

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Background : Bariatric surgery remains the only proven mechanism for inducing sustained and significant weight loss for morbidly obese patients. Glycemic control is better after the surgery. Changes in gastric emptying patterns which occurs in patients after surgical treatment may be contributing to weight loss and better glucose metabolism. The aim of the study is to see effect of Laparoscopic sleeve gastrectomy (LSG) on gastric emptying time. Methods: This was a prospective observational study. 24 patients were recruited who underwent LSG. The patients were submitted to the Gastric emptying study preoperatively and at 3 months after LSG. Gastric emptying time for solids was done. Results: At 3 months the Excess weight loss was 24 %. Five of the 7 patients with diabetes had complete resolution. There was a significant decrease in the mean T 1/2 of gastric empting at 3 months postoperatively (83.4 min vs 33.3 min). No correlation was found between Gastric emptying half time and %EWL at 3 months. Conclusion: Gastric emptying after LSG is accelerated in the majority of patients as shown by significantly reduced gastric emptying time. A faster gastric emptying could be one of the mechanisms contributing to weight loss after LSG

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Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus

Cited by 140 publications

References 22 publications

Sleeve gastrectomy effects on hunger, satiation, and gastrointestinal hormone and motility responses after a liquid meal test

Sleeve gastrectomy effects on hunger, satiation, and gastrointestinal hormone and motility responses after a liquid meal test

Ghrelin and Obesity: Identifying Gaps and Dispelling Myths. A Reappraisal

Gastric Emptying Time after Laparoscopic Sleeve Gastrectomy

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