The effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study

Sista, Federico; Abruzzese, Valentina; Clementi, Marco; Carandina, Sergio; Cecilia, Manuela; Amicucci, Gianfranco

doi:10.1016/j.soard.2016.08.004

Cited by 72 publications

(36 citation statements)

References 32 publications

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“…On the one hand, several studies have reported accelerated gastric emptying following sleeve gastrectomy. This may result from the reduction in volume of the gastric reservoir which is specific to the proximal stomach which may lead to increased intragastric pressure after meals, resulting in accelerated passage of nutriments to the small bowel . On the other hand, the resection of the gastric pacemaker zone during sleeve gastrectomy can result in aberrant distal ectopic pacemaking or bioelectrical quiescence according to results from a recent study .…”

Section: Discussionmentioning

confidence: 99%

Pyloric distensibility measurement after gastric surgery: Which surgeries are associated with pylorospasm?

Desprez

Melchior

Wuestenberghs

et al. 2020

Neurogastroenterology Motil

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Background and study aims: History of gastric surgery is found in 10% of patients with gastroparesis, and vagal lesion is often suspected to be the cause of pylorospasm. Recently, pyloric distensibility measurement using the EndoFLIP ® system showed that pylorospasm was present in 30%-50% of gastroparetic patients. Our objective was to assess whether pylorospasm, diagnosed using EndoFLIP ® system was observed in three different types of gastric surgeries: antireflux surgery, sleeve gastrectomy, and esophagectomy. Patients and Methods:Pyloric distensibility and pressure were measured using the EndoFLIP ® system in 43 patients from two centers (18 antireflux surgery, 16 sleeve gastrectomy, and nine esophagectomy) with dyspeptic symptoms after gastric surgery, and in 21 healthy volunteers. Altered pyloric distensibility was defined as distensibility below 10 mm 2 /mm Hg as previously reported.Results: Compared to healthy volunteers (distensibility: 25.2 ± 2.4 mm 2 /mm Hg; pressure: 9.7 ± 4.4 mm Hg), pyloric distensibility was decreased in 61.1% of patients in the antireflux surgery group (14.5 ± 3.4 mm 2 /mm Hg; P < .01) and 75.0% of patients in the esophagectomy group (10.8 ± 2.1 mm 2 /mm Hg; P < .05), while pyloric pressure was only increased in the antireflux surgery group (18.9 ± 2.2 mm Hg; P < .01). Pyloric distensibility and pressure were similar in healthy volunteers and in sleeve gastrectomy (distensibility: 20.3 ± 3.8 mm 2 /mm Hg; pressure: 15.8 ± 1.6 mm Hg) groups, with decreased pyloric distensibility affecting 18.7% of sleeve gastrectomy patients. Conclusion:Antireflux surgery and esophagectomy were associated with pylorospasm although pylorospasm was not found in all patients. Sleeve gastrectomy was not associated with altered pyloric distensibility nor altered pyloric pressure.

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Section: Discussionmentioning

confidence: 99%

Pyloric distensibility measurement after gastric surgery: Which surgeries are associated with pylorospasm?

Desprez

Melchior

Wuestenberghs

et al. 2020

Neurogastroenterology Motil

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“…One mechanism proposed for weight loss after VSG is rapid gastric emptying, quickly pushing nutrients to more distal portions of the small intestine, and subsequent changes in gut hormone secretion [39], or perhaps changes in bile acid reabsorption and signaling [25]. It could thus be hypothesized that this pathway is less affected or recovers faster in cases with weight regain after VSG, such as in our mouse model or in many patients with VSG.…”

Section: Discussionmentioning

confidence: 99%

RYGB Produces more Sustained Body Weight Loss and Improvement of Glycemic Control Compared with VSG in the Diet-Induced Obese Mouse Model

et al. 2017

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Objective To compare the effects of murine models of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) surgery on body weight, body composition, food intake, energy expenditure, and glycemic control. Background Weight regain and type-2 diabetes relapse has been reported in a significant proportion of VSG patients in some studies, but definitive conclusions regarding the long-term comparative effectiveness of VSG and RYGB are lacking both in humans and rodent models. Methods VSG, RYGB, and sham surgery was performed in high-fat diet-induced obese mice and the effects on body weight and glycemic control were observed for a period of 12 weeks. Results After the initial weight loss, VSG mice regained significant amounts of body weight and fat mass that were only marginally lower than in sham-operated mice. In contrast, RYGB produced sustained loss of body weight and fat mass up to 12 weeks, and drastically improved fasting insulin and HOMA-IR compared with sham-operated mice. Using weight-matched control groups we also found that the adaptive hypometabolic response to weight loss was blunted by both VSG and RYGB, and that despite large weight/fat regain, fasting insulin and HOMA-IR were markedly improved, but not reversed, in VSG mice. Conclusions VSG is less effective to lastingly suppress body weight and improve glycemic control compared with RYGB in mice. Given similar observations in many human studies, the run towards replacing RYGB with VSG is premature and should await carefully controlled randomized long term trials with VSG and RYGB.

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“…Laparoscopic sleeve gastrectomy is associated with accelerated gastric emptying, which may decrease the dissolution of levothyroxine tablets and reduce their absorption 7. Complete solubility of levothyroxine is achieved at pH approximately 1 (ie, stomach in fasted state) whereas at higher pH (after a meal) it is a low-solubility drug.…”

Section: Discussionmentioning

confidence: 99%

Major imbalance of thyroid function after laparoscopic sleeve gastrectomy

Brutus¹,

Poupard

Glatin

2019

BMJ Case Rep

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In patients with substituted hypothyroidism, laparoscopic sleeve gastrectomy may interfere with thyroid balance by varying body weight or by altering the absorption of hormone therapy. A 58-year-old female patient presented with a major thyroid imbalance after sleeve gastrectomy, manifesting itself in large-scale changes in thyroid stimulating hormone (TSH) levels. The transition from a tablet treatment to a liquid form alleviated burden of treatment, unfortunately without normalising TSH. Our case emphasises the importance of the understanding of hypothalamic–pituitary–thyroid feedback control mechanisms together with good galenic choice, management of associated conditions and the elimination of other causes of variations of TSH levels during the management of hypothyroid patients after sleeve gastrectomy.

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The effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study

Cited by 72 publications

References 32 publications

Pyloric distensibility measurement after gastric surgery: Which surgeries are associated with pylorospasm?

Pyloric distensibility measurement after gastric surgery: Which surgeries are associated with pylorospasm?

RYGB Produces more Sustained Body Weight Loss and Improvement of Glycemic Control Compared with VSG in the Diet-Induced Obese Mouse Model

Major imbalance of thyroid function after laparoscopic sleeve gastrectomy

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