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Erschienen in: Obesity Surgery 2/2019

07.11.2018 | Original Contributions

Gastric Emptying and Food Tolerance Following Banded and Non-banded Roux-en-Y Gastric Bypass

verfasst von: Galzuinda Maria Figueiredo Reis, Carlos Alberto Malheiros, Paulo Roberto Savassi-Rocha, Omar Lopes Cançado Júnior, Fábio Rodrigues Thuler, Mauro Lima Faria, Vicente Guerra Filho

Erschienen in: Obesity Surgery | Ausgabe 2/2019

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Abstract

Introduction

Gastric emptying (GE) and food tolerance (FT) can be altered after Roux-en-Y gastric bypass (RYGB) has been performed, especially when it involved the use of a restrictive mechanism (such as a silastic ring).

Aim

To assess GE and FT in patients who underwent banded (BRYGB) or non-banded Roux-en-Y gastric bypass (RYGB).

Methods

Forty-seven BRYGB patients and 47 RYGB patients underwent gastric emptying scintigraphy (GES) and FT assessment (by means of a questionnaire) between 6 months and 2 years postoperatively.

Results

GES was performed on average 11.7 ± 5.0 months (6 to 24) postoperatively. T½ medians (time taken for the gastric radioactivity to decrease to half of the original value in the gastric pouch) in the RYGB and BRYGB groups were 48.7 min (40.6–183.0 min) and 56.3 min (41.1–390.9 min), respectively (p = 0.031). The median of total questionnaire scores was 24 points (18–27) in the RYGB group and 20 points (13–27) in the BRYBG group (p < 0.001).

Conclusions

The band (silastic ring) delays GE time and does not affect patient satisfaction or food tolerance to vegetables, bread, or rice, but does affect tolerance to the intake of meat, salad, and pasta. The best tolerated foods are vegetables, salad, and fish. Banded patients are more likely to regurgitate and vomit. Gastric emptying does not affect FT.
Literatur
2.
Zurück zum Zitat Horner KM, Byrne NM, Cleghorn GJ, et al. The effects of weight loss strategies on gastric emptying and appetite control. Obes Rev. 2011;12:935–51.CrossRef Horner KM, Byrne NM, Cleghorn GJ, et al. The effects of weight loss strategies on gastric emptying and appetite control. Obes Rev. 2011;12:935–51.CrossRef
3.
Zurück zum Zitat Wang G, Agenor K, Pizot J, et al. Accelerated gastric emptying but no carbohydrate malabsorption 1 year after gastric bypass surgery (GBP). Obes Surg. 2012;22:1263–7.CrossRef Wang G, Agenor K, Pizot J, et al. Accelerated gastric emptying but no carbohydrate malabsorption 1 year after gastric bypass surgery (GBP). Obes Surg. 2012;22:1263–7.CrossRef
4.
Zurück zum Zitat Dirksen C, Damgaard M, Bojsen-Møller KN, et al. Fast pouch emptying, delayed small intestinal transit, and exaggerated gut hormone responses after Roux-en-Y gastric bypass. Neurogastroenterol Motil. 2013;25:346–e255.CrossRef Dirksen C, Damgaard M, Bojsen-Møller KN, et al. Fast pouch emptying, delayed small intestinal transit, and exaggerated gut hormone responses after Roux-en-Y gastric bypass. Neurogastroenterol Motil. 2013;25:346–e255.CrossRef
5.
Zurück zum Zitat Fobi M, Lee H, Flemming A. The surgical technique of the banded Roux-en-Y gastric bypass. J Obes Weight Regulation. 1989;8:99–102. Fobi M, Lee H, Flemming A. The surgical technique of the banded Roux-en-Y gastric bypass. J Obes Weight Regulation. 1989;8:99–102.
6.
Zurück zum Zitat Capella RF, Capella JF, Mandec H, et al. Vertical banded gastroplasty-gastric bypass: preliminary report. Obes Surg. 1991;1:389–95.CrossRef Capella RF, Capella JF, Mandec H, et al. Vertical banded gastroplasty-gastric bypass: preliminary report. Obes Surg. 1991;1:389–95.CrossRef
7.
Zurück zum Zitat Le Roux CW, Bloom SR. Why do patients lose weight after Roux-en-Y gastric bypass? J Clin Endocrinol Metab. 2005;90:591–2.CrossRef Le Roux CW, Bloom SR. Why do patients lose weight after Roux-en-Y gastric bypass? J Clin Endocrinol Metab. 2005;90:591–2.CrossRef
8.
Zurück zum Zitat Rasera Jr I, Coelho TH, Ravelli MN, et al. A comparative, prospective and randomized evaluation of Roux-en-Y gastric bypass with and without the silastic ring: a 2-year follow up preliminary report on weight loss and quality of life. Obes Surg. 2016;26:762–8.CrossRef Rasera Jr I, Coelho TH, Ravelli MN, et al. A comparative, prospective and randomized evaluation of Roux-en-Y gastric bypass with and without the silastic ring: a 2-year follow up preliminary report on weight loss and quality of life. Obes Surg. 2016;26:762–8.CrossRef
9.
Zurück zum Zitat Karcz WK, Suslin D, Baumann T, et al. To have or not to have the ring: early and late surgical complications after banded Roux-en-Y gastric bypass. Videosurg Miniinvasive Tech. 2008;3:53–65. Karcz WK, Suslin D, Baumann T, et al. To have or not to have the ring: early and late surgical complications after banded Roux-en-Y gastric bypass. Videosurg Miniinvasive Tech. 2008;3:53–65.
10.
Zurück zum Zitat Blackburn GL, Hutter MM, Harvey AM, et al. Expert panel on weight loss surgery: executive report update. Obesity (Silver Spring). 2009;17:842–62.CrossRef Blackburn GL, Hutter MM, Harvey AM, et al. Expert panel on weight loss surgery: executive report update. Obesity (Silver Spring). 2009;17:842–62.CrossRef
11.
Zurück zum Zitat Elias AA, GarridoJúnior AB, Berti LV, et al. Derivações gástrica sem Y-de-Roux com anel de silicone para o tratamento da obesidade: estudo das complicações relacionadas com o anel. Arq Bras Cir Dig. 2011;24:290–5.CrossRef Elias AA, GarridoJúnior AB, Berti LV, et al. Derivações gástrica sem Y-de-Roux com anel de silicone para o tratamento da obesidade: estudo das complicações relacionadas com o anel. Arq Bras Cir Dig. 2011;24:290–5.CrossRef
12.
Zurück zum Zitat Camilleri M, Hasler WL, Parkman HP, et al. Measurement of gastrointestinal motility in the GI laboratory. Gastroenterology. 1998;115:747–62.CrossRef Camilleri M, Hasler WL, Parkman HP, et al. Measurement of gastrointestinal motility in the GI laboratory. Gastroenterology. 1998;115:747–62.CrossRef
13.
Zurück zum Zitat Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44–54.CrossRef Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44–54.CrossRef
14.
Zurück zum Zitat Schweiger C, Weiss R, Keidar A. Effect of different bariatric operations on food tolerance and quality of eating. Obes Surg. 2010;20:1393–9.CrossRef Schweiger C, Weiss R, Keidar A. Effect of different bariatric operations on food tolerance and quality of eating. Obes Surg. 2010;20:1393–9.CrossRef
15.
Zurück zum Zitat Godoy CM, Caetano AL, Viana KR, et al. Food tolerance in patients submitted to gastric bypass: the importance of using an integrated and interdisciplinary approach. Obes Surg. 2012;22:124–30.CrossRef Godoy CM, Caetano AL, Viana KR, et al. Food tolerance in patients submitted to gastric bypass: the importance of using an integrated and interdisciplinary approach. Obes Surg. 2012;22:124–30.CrossRef
16.
Zurück zum Zitat Heneghan HM, Annaberdyev S, Eldar S, et al. Banded Roux-en-Y gastric bypass for the treatment of morbid obesity. Surg Obes Relat Dis. 2014;10:210–6.CrossRef Heneghan HM, Annaberdyev S, Eldar S, et al. Banded Roux-en-Y gastric bypass for the treatment of morbid obesity. Surg Obes Relat Dis. 2014;10:210–6.CrossRef
17.
Zurück zum Zitat Overs SE, Freeman RA, Zarshenas N, et al. Food tolerance and gastrointestinal quality of life following three bariatric procedures: adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Obes Surg. 2012;22:536–43.CrossRef Overs SE, Freeman RA, Zarshenas N, et al. Food tolerance and gastrointestinal quality of life following three bariatric procedures: adjustable gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy. Obes Surg. 2012;22:536–43.CrossRef
18.
Zurück zum Zitat Stumpf MAM, Rodrigues MRS, Kluthcovsky ACGC, et al. Análise da tolerânciaalimentarempacientessubmetidos à cirurgiabariátricaatravés do questionárioQualityofAlimentation. Arq Bras Cir Dig. 2015;28:79–83.CrossRef Stumpf MAM, Rodrigues MRS, Kluthcovsky ACGC, et al. Análise da tolerânciaalimentarempacientessubmetidos à cirurgiabariátricaatravés do questionárioQualityofAlimentation. Arq Bras Cir Dig. 2015;28:79–83.CrossRef
20.
Zurück zum Zitat Cruz MRR, Morimoto IMI. Intervençãonutricional no tratamentocirúrgico da obesidademórbida: resultados de um protocolodiferenciado. Rev Nutr. 2004;17:263–72.CrossRef Cruz MRR, Morimoto IMI. Intervençãonutricional no tratamentocirúrgico da obesidademórbida: resultados de um protocolodiferenciado. Rev Nutr. 2004;17:263–72.CrossRef
21.
Zurück zum Zitat Mason EE, Ito C. Gastric bypass in obesity. Surg Clin N Am. 1967;47:1345–51.CrossRef Mason EE, Ito C. Gastric bypass in obesity. Surg Clin N Am. 1967;47:1345–51.CrossRef
22.
Zurück zum Zitat Lemmens L, Karcz WK, Bukhari W, et al. Banded gastric bypass - four years follow up in a prospective multicenter analysis. BMC Surg. 2014;14:88.CrossRef Lemmens L, Karcz WK, Bukhari W, et al. Banded gastric bypass - four years follow up in a prospective multicenter analysis. BMC Surg. 2014;14:88.CrossRef
23.
Zurück zum Zitat Lemmens L. Banded gastric bypass: better long-term results? A cohort study with minimum 5-year follow-up. Obes Surg. 2017;27:864–72.CrossRef Lemmens L. Banded gastric bypass: better long-term results? A cohort study with minimum 5-year follow-up. Obes Surg. 2017;27:864–72.CrossRef
24.
Zurück zum Zitat Dapri G, Cadière GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-Y gastric bypass. Obes Surg. 2009;19:650–4.CrossRef Dapri G, Cadière GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-Y gastric bypass. Obes Surg. 2009;19:650–4.CrossRef
25.
Zurück zum Zitat Valk J, Hendrickx L, Abdelgabar A, et al. Revisional surgery for weight regain or insufficient weight loss after gastric bypass surgery using the minimizer-ring: short term results of a multicenter study. Obes Surg. 2015;25:S116–7. Valk J, Hendrickx L, Abdelgabar A, et al. Revisional surgery for weight regain or insufficient weight loss after gastric bypass surgery using the minimizer-ring: short term results of a multicenter study. Obes Surg. 2015;25:S116–7.
26.
Zurück zum Zitat Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149:275–87.CrossRef Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149:275–87.CrossRef
27.
Zurück zum Zitat Vasavid P, Chaiwatanarat T, Pusuwan P, et al. Normal solid gastric emptying values measured by scintigraphy using Asian-style meal: a multicenter study in healthy volunteers. J Neurogastroenterol Motil. 2014;20:371–8.CrossRef Vasavid P, Chaiwatanarat T, Pusuwan P, et al. Normal solid gastric emptying values measured by scintigraphy using Asian-style meal: a multicenter study in healthy volunteers. J Neurogastroenterol Motil. 2014;20:371–8.CrossRef
28.
Zurück zum Zitat Júnior JM, Herbella F, Valezi AC, et al. Correlation between gastric emptying time and weight loss after silastic ring Roux-en-Y gastric bypass. Gastroenterology. 2012;142:S–1083.CrossRef Júnior JM, Herbella F, Valezi AC, et al. Correlation between gastric emptying time and weight loss after silastic ring Roux-en-Y gastric bypass. Gastroenterology. 2012;142:S–1083.CrossRef
29.
Zurück zum Zitat Riccioppo D, Santo MA, Rocha M, et al. Small-volume, fast-emptying gastric pouch leads to better long-term weight loss and food tolerance after Roux-en-Y gastric bypass. Obes Surg. 2018;28:693–701.CrossRef Riccioppo D, Santo MA, Rocha M, et al. Small-volume, fast-emptying gastric pouch leads to better long-term weight loss and food tolerance after Roux-en-Y gastric bypass. Obes Surg. 2018;28:693–701.CrossRef
30.
Zurück zum Zitat Freeman RA, Overs SE, Zarshenas N, et al. Food tolerance and diet quality following adjustable gastric banding, sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Res Clin Pract. 2014;8:e115–200.CrossRef Freeman RA, Overs SE, Zarshenas N, et al. Food tolerance and diet quality following adjustable gastric banding, sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Res Clin Pract. 2014;8:e115–200.CrossRef
31.
Zurück zum Zitat Cano-Valderrama O, Sánchez-Pernaute A, Rubio-Herrera MA, et al. Long-term food tolerance after bariatric surgery: comparison of three different surgical techniques. Obes Surg. 2017;27:2868–72.CrossRef Cano-Valderrama O, Sánchez-Pernaute A, Rubio-Herrera MA, et al. Long-term food tolerance after bariatric surgery: comparison of three different surgical techniques. Obes Surg. 2017;27:2868–72.CrossRef
32.
Zurück zum Zitat McMahon MM, Sarr MG, Clark MM, et al. Clinical management after bariatric surgery: value of a multidisciplinary approach. Mayo Clin Proc. 2006;81:S34–45.CrossRef McMahon MM, Sarr MG, Clark MM, et al. Clinical management after bariatric surgery: value of a multidisciplinary approach. Mayo Clin Proc. 2006;81:S34–45.CrossRef
33.
Zurück zum Zitat Pandolfino JE, Krishnamoorthy B, Lee TJ. Gastrointestinal complications of obesity surgery. Med Gen Med. 2004;6(2):15. Pandolfino JE, Krishnamoorthy B, Lee TJ. Gastrointestinal complications of obesity surgery. Med Gen Med. 2004;6(2):15.
Metadaten
Titel
Gastric Emptying and Food Tolerance Following Banded and Non-banded Roux-en-Y Gastric Bypass
verfasst von
Galzuinda Maria Figueiredo Reis
Carlos Alberto Malheiros
Paulo Roberto Savassi-Rocha
Omar Lopes Cançado Júnior
Fábio Rodrigues Thuler
Mauro Lima Faria
Vicente Guerra Filho
Publikationsdatum
07.11.2018
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 2/2019
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3561-9

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