Saed A Jaber, MD, Basma M Fallatah, MD, Abdel- Aziz Shehry, MD, Mahmoud Abdelmoeti, MD. King Fahd Medical Military complex
BACKGROUND: Sleeve gastrectomy (SG) has been became a primary surgical treatment for obesity. This operation could be associated with motor gastric dysfunction and abnormal gastric emptying. The purpose of this prospective study is to present a comparison study of gastric emptying to solids after performing sleeve gastrectomy with two different techniques using scintigraphy. METHODS: Prospectively; twenty morbidly obese patients were submitted for laparoscopic SG. After excluding patients with gastro-esophageal reflux disease and diabetes mellitus for the sake of avoiding having a preoperative gastric emptying, patients were divided into two groups. One group (3 males, 7 females) had sleeve gastrectomy started 7 cm from the pylorus and then vertical gastrectomy a long a 40 french size tube and the other group (3 males, 7 females ) has the sleeve started at 4 cm from the pylorus and then vertical gastrectomy a long a 40 french size gastric tube . Gastric emptying of solids was measured by scintigraphic technique. RESULTS: At 4 cm from the pylorus: Nine of ten patients had delayed gastric emptying with t1/2 >50 min (55-133 min).Mean BMI decreased from 42.1Kg/m2 to 36Kg/m2. All female patients were complaining from significant nausea and vomiting postoperatively that persisted for 6 months. At 7 cm from pylorus: Ten patients had rapid gastric emptying with t1/2<30 min(17-29 min) . BMI decreased from 42.1Kg\m2 to 37.1Kg/m2. From these cases one female patient developed nausea in a chronic manner. Conclusion: Gastric emptying after SG is variable according to point of starting sleeve gastrectomy from the pylorus. At 4 cm it is associated with delayed emptying and at 7 cm it is associated with accelerated emptying for solids in the majority of patients. These results could be in consideration to select the appropriate technique according to gender and preoperative foregut condition.
Session Number: SS09 – Obesity Surgery
Program Number: S052