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Erschienen in: Der Chirurg 9/2015

01.09.2015 | Bariatrische Chirurgie | Leitthema

Dumping-Syndrom

Diagnostik und Therapieoptionen

verfasst von: Dr. F. Seyfried, A. Wierlemann, M. Bala, M. Fassnacht, C. Jurowich

Erschienen in: Die Chirurgie | Ausgabe 9/2015

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Zusammenfassung

Hintergrund

Das Dumping-Syndrom ist ein häufiges Phänomen nach Chirurgie des oberen Gastrointestinaltrakts. Die Bandbreite der Symptome umfasst milde gastrointestinale Beschwerden, über moderate vasomotorische Störungen bis hin zu schweren hyperinsulinämen Hypoglykämien. Durch die weltweit stetig steigende Zahl bariatrischer Operationen ist die bariatrische Chirurgie mittlerweile der häufigste Grund dieser Krankheitsentität.

Zielsetzung

In diesem Review soll die vorhandene Datenlage zum Dumping-Syndrom nach bariatrischer Chirurgie – insbesondere nach Roux-en-Y-Magenbypass und Magenschlauchbildung (Sleeve) – unter besonderer Berücksichtigung der dafür spezifischen Pathophysiologie, etwaiger Vermeidungsstrategien im Sinne operationstaktischer Überlegungen und Patientenselektion, Differenzialdiagnose und gradueller Diagnostik sowie möglicher Therapieoptionen dargestellt und diskutiert werden.
Literatur
1.
Zurück zum Zitat Buchwald H, Oien DM (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23(4):427–436CrossRefPubMed Buchwald H, Oien DM (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23(4):427–436CrossRefPubMed
2.
Zurück zum Zitat Nguyen NT et al (2013) Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg 216(2):252–257CrossRefPubMed Nguyen NT et al (2013) Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg 216(2):252–257CrossRefPubMed
3.
Zurück zum Zitat Pallati P et al (2012) Trends in adolescent bariatric surgery evaluated by UHC database collection. Surg Endosc 26(11):3077–3081CrossRefPubMed Pallati P et al (2012) Trends in adolescent bariatric surgery evaluated by UHC database collection. Surg Endosc 26(11):3077–3081CrossRefPubMed
4.
Zurück zum Zitat Carlin AM et al (2013) The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg 257(5):791–797CrossRefPubMed Carlin AM et al (2013) The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg 257(5):791–797CrossRefPubMed
5.
Zurück zum Zitat Runkel N et al (2011) Evidence-based German guidelines for surgery for obesity. Int J Colorectal Dis 26(4):397–404CrossRefPubMed Runkel N et al (2011) Evidence-based German guidelines for surgery for obesity. Int J Colorectal Dis 26(4):397–404CrossRefPubMed
6.
7.
Zurück zum Zitat Hertz AF (1913) The cause and treatment of certain unfavourable after-effects of gastro-enterostomy. Proc R Soc Med 6(Surg Sect):155–163PubMedPubMedCentral Hertz AF (1913) The cause and treatment of certain unfavourable after-effects of gastro-enterostomy. Proc R Soc Med 6(Surg Sect):155–163PubMedPubMedCentral
8.
Zurück zum Zitat Tack J et al (2009) Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol 6(10):583–590CrossRefPubMed Tack J et al (2009) Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol 6(10):583–590CrossRefPubMed
9.
Zurück zum Zitat Abell T, Minocha A (2006) Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci 331(4):214–218CrossRefPubMed Abell T, Minocha A (2006) Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci 331(4):214–218CrossRefPubMed
10.
Zurück zum Zitat Abellan P et al (2008) Severe hypoglycemia after gastric bypass surgery for morbid obesity. Diabetes Res Clin Pract 79(1):e7–e9CrossRef Abellan P et al (2008) Severe hypoglycemia after gastric bypass surgery for morbid obesity. Diabetes Res Clin Pract 79(1):e7–e9CrossRef
11.
Zurück zum Zitat Banerjee A et al (2013) The role of dumping syndrome in weight loss after gastric bypass surgery. Surg Endosc 27(5):1573–1578CrossRefPubMed Banerjee A et al (2013) The role of dumping syndrome in weight loss after gastric bypass surgery. Surg Endosc 27(5):1573–1578CrossRefPubMed
12.
Zurück zum Zitat Ceppa EP et al (2012) Algorithm to diagnose etiology of hypoglycemia after Roux-en-Y gastric bypass for morbid obesity: case series and review of the literature. Surg Obes Relat Dis 8(5):641–647CrossRefPubMed Ceppa EP et al (2012) Algorithm to diagnose etiology of hypoglycemia after Roux-en-Y gastric bypass for morbid obesity: case series and review of the literature. Surg Obes Relat Dis 8(5):641–647CrossRefPubMed
13.
Zurück zum Zitat Dirksen C et al (2013) Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass. Int J Obes (Lond) 37(11):1452–1459CrossRef Dirksen C et al (2013) Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass. Int J Obes (Lond) 37(11):1452–1459CrossRef
14.
Zurück zum Zitat Frantzides CT et al (2011) A survey of dumping symptomatology after gastric bypass with or without lesser omental transection. Obes Surg 21(2):186–193CrossRefPubMed Frantzides CT et al (2011) A survey of dumping symptomatology after gastric bypass with or without lesser omental transection. Obes Surg 21(2):186–193CrossRefPubMed
15.
Zurück zum Zitat Kellogg TA et al (2008) Postgastric bypass hyperinsulinemic hypoglycemia syndrome: characterization and response to a modified diet. Surg Obes Relat Dis 4(4):492–499CrossRefPubMed Kellogg TA et al (2008) Postgastric bypass hyperinsulinemic hypoglycemia syndrome: characterization and response to a modified diet. Surg Obes Relat Dis 4(4):492–499CrossRefPubMed
16.
Zurück zum Zitat Tack J, Deloose E (2014) Complications of bariatric surgery: dumping syndrome, reflux and vitamin deficiencies. Best Pract Res Clin Gastroenterol 28(4):741–749CrossRefPubMed Tack J, Deloose E (2014) Complications of bariatric surgery: dumping syndrome, reflux and vitamin deficiencies. Best Pract Res Clin Gastroenterol 28(4):741–749CrossRefPubMed
17.
Zurück zum Zitat Z’Graggen K et al (2008) Severe recurrent hypoglycemia after gastric bypass surgery. Obes Surg 18(8):981–988CrossRef Z’Graggen K et al (2008) Severe recurrent hypoglycemia after gastric bypass surgery. Obes Surg 18(8):981–988CrossRef
18.
Zurück zum Zitat Papamargaritis D et al (2012) Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy. Obes Surg 22(10):1600–1606CrossRefPubMed Papamargaritis D et al (2012) Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy. Obes Surg 22(10):1600–1606CrossRefPubMed
19.
Zurück zum Zitat Tzovaras G et al (2012) Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy. Obes Surg 22(1):23–28CrossRefPubMed Tzovaras G et al (2012) Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy. Obes Surg 22(1):23–28CrossRefPubMed
20.
Zurück zum Zitat Clancy TE, Moore FD Jr, Zinner MJ (2006) Post-gastric bypass hyperinsulinism with nesidioblastosis: subtotal or total pancreatectomy may be needed to prevent recurrent hypoglycemia. J Gastrointest Surg 10(8):1116–1119CrossRefPubMed Clancy TE, Moore FD Jr, Zinner MJ (2006) Post-gastric bypass hyperinsulinism with nesidioblastosis: subtotal or total pancreatectomy may be needed to prevent recurrent hypoglycemia. J Gastrointest Surg 10(8):1116–1119CrossRefPubMed
21.
Zurück zum Zitat Dapri G, Cadiere GB, Himpens J (2011) Laparoscopic reconversion of Roux-en-Y gastric bypass to original anatomy: technique and preliminary outcomes. Obes Surg 21(8):1289–1295CrossRefPubMed Dapri G, Cadiere GB, Himpens J (2011) Laparoscopic reconversion of Roux-en-Y gastric bypass to original anatomy: technique and preliminary outcomes. Obes Surg 21(8):1289–1295CrossRefPubMed
22.
Zurück zum Zitat Huang CK et al (2015) Laparoscopic conversion to loop duodenojejunal bypass with sleeve gastrectomy for intractable dumping syndrome after Roux-en-Y gastric bypass – two case reports. Obes Surg 25(5):947CrossRefPubMed Huang CK et al (2015) Laparoscopic conversion to loop duodenojejunal bypass with sleeve gastrectomy for intractable dumping syndrome after Roux-en-Y gastric bypass – two case reports. Obes Surg 25(5):947CrossRefPubMed
23.
Zurück zum Zitat Huang CK et al (2015) Conversion to modified duodenal switch for relieving intractable dumping syndrome and constipation after laparoscopic Roux-en-Y gastric bypass. Obes Surg 25(5):946CrossRefPubMed Huang CK et al (2015) Conversion to modified duodenal switch for relieving intractable dumping syndrome and constipation after laparoscopic Roux-en-Y gastric bypass. Obes Surg 25(5):946CrossRefPubMed
24.
Zurück zum Zitat Zurita Mv LC, Tabari M, Hong D (2013) Laparoscopic conversion of laparoscopic Roux-en-Y gastric bypass to laparoscopic sleeve gastrectomy for intractable dumping syndrome and excessive weight loss. Surg Obes Relat Dis 9(2):e34–e37CrossRef Zurita Mv LC, Tabari M, Hong D (2013) Laparoscopic conversion of laparoscopic Roux-en-Y gastric bypass to laparoscopic sleeve gastrectomy for intractable dumping syndrome and excessive weight loss. Surg Obes Relat Dis 9(2):e34–e37CrossRef
25.
Zurück zum Zitat MacGregor I, Parent J, Meyer JH (1977) Gastric emptying of liquid meals and pancreatic and biliary secretion after subtotal gastrectomy or truncal vagotomy and pyloroplasty in man. Gastroenterology 72(2):195–205PubMed MacGregor I, Parent J, Meyer JH (1977) Gastric emptying of liquid meals and pancreatic and biliary secretion after subtotal gastrectomy or truncal vagotomy and pyloroplasty in man. Gastroenterology 72(2):195–205PubMed
26.
Zurück zum Zitat Mayer EA et al (1984) Gastric emptying and sieving of solid food and pancreatic and biliary secretions after solid meals in patients with nonresective ulcer surgery. Gastroenterology 87(6):1264–1271PubMed Mayer EA et al (1984) Gastric emptying and sieving of solid food and pancreatic and biliary secretions after solid meals in patients with nonresective ulcer surgery. Gastroenterology 87(6):1264–1271PubMed
27.
Zurück zum Zitat Eloy R et al (1975) Jejunal factor stimulating insulin release in the isolated perfused canine pancreas and jejunum. Horm Metab Res 7(6):461–467CrossRefPubMed Eloy R et al (1975) Jejunal factor stimulating insulin release in the isolated perfused canine pancreas and jejunum. Horm Metab Res 7(6):461–467CrossRefPubMed
28.
Zurück zum Zitat Toft-Nielsen M, Madsbad S, Holst JJ (1998) Exaggerated secretion of glucagon-like peptide-1 (GLP-1) could cause reactive hypoglycaemia. Diabetologia 41(10):1180–1186CrossRefPubMed Toft-Nielsen M, Madsbad S, Holst JJ (1998) Exaggerated secretion of glucagon-like peptide-1 (GLP-1) could cause reactive hypoglycaemia. Diabetologia 41(10):1180–1186CrossRefPubMed
29.
Zurück zum Zitat Mason EE, Ito C (1967) Gastric bypass in obesity. Surg Clin North Am 47(6):1345–1351PubMed Mason EE, Ito C (1967) Gastric bypass in obesity. Surg Clin North Am 47(6):1345–1351PubMed
30.
Zurück zum Zitat Bjorklund P, Lonroth H, Fandriks L (2015) Manometry of the upper gut following Roux-en-Y gastric bypass indicates that the gastric pouch and Roux limb act as a common cavity. Obes Surg. 2015 Mar 4. [Epub ahead of print] Bjorklund P, Lonroth H, Fandriks L (2015) Manometry of the upper gut following Roux-en-Y gastric bypass indicates that the gastric pouch and Roux limb act as a common cavity. Obes Surg. 2015 Mar 4. [Epub ahead of print]
31.
Zurück zum Zitat Cottam DR et al (2009) The effect of stoma size on weight loss after laparoscopic gastric bypass surgery: results of a blinded randomized controlled trial. Obes Surg 19(1):13–17CrossRefPubMed Cottam DR et al (2009) The effect of stoma size on weight loss after laparoscopic gastric bypass surgery: results of a blinded randomized controlled trial. Obes Surg 19(1):13–17CrossRefPubMed
32.
Zurück zum Zitat Goyal V, Holover S, Garber S (2013) Gastric pouch reduction using StomaphyX in post Roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis. Surg Endosc 27(9):3417–3420CrossRefPubMed Goyal V, Holover S, Garber S (2013) Gastric pouch reduction using StomaphyX in post Roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis. Surg Endosc 27(9):3417–3420CrossRefPubMed
33.
Zurück zum Zitat Heneghan HM et al (2012) Influence of pouch and stoma size on weight loss after gastric bypass. Surg Obes Relat Dis 8(4):408–415CrossRefPubMed Heneghan HM et al (2012) Influence of pouch and stoma size on weight loss after gastric bypass. Surg Obes Relat Dis 8(4):408–415CrossRefPubMed
34.
Zurück zum Zitat Topart P, Becouarn G, Ritz P (2011) Pouch size after gastric bypass does not correlate with weight loss outcome. Obes Surg 21(9):1350–1354CrossRefPubMed Topart P, Becouarn G, Ritz P (2011) Pouch size after gastric bypass does not correlate with weight loss outcome. Obes Surg 21(9):1350–1354CrossRefPubMed
36.
Zurück zum Zitat Fernandez-Esparrach G, Lautz DB, Thompson CC (2010) Peroral endoscopic anastomotic reduction improves intractable dumping syndrome in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis 6(1):36–40CrossRefPubMed Fernandez-Esparrach G, Lautz DB, Thompson CC (2010) Peroral endoscopic anastomotic reduction improves intractable dumping syndrome in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis 6(1):36–40CrossRefPubMed
37.
Zurück zum Zitat Goldfine AB et al (2007) Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab 92(12):4678–4685CrossRefPubMed Goldfine AB et al (2007) Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab 92(12):4678–4685CrossRefPubMed
38.
Zurück zum Zitat Jimenez A et al (2015) Remission of type 2 diabetes after Roux-en-Y gastric bypass or sleeve gastrectomy is associated with a distinct glycemic profile. Ann Surg 261(2):316–322CrossRefPubMed Jimenez A et al (2015) Remission of type 2 diabetes after Roux-en-Y gastric bypass or sleeve gastrectomy is associated with a distinct glycemic profile. Ann Surg 261(2):316–322CrossRefPubMed
39.
Zurück zum Zitat Lutz TA, Bueter M (2014) The physiology underlying Roux-en-Y gastric bypass: a status report. Am J Physiol Regul Integr Comp Physiol 307(11):R1275–R1291CrossRef Lutz TA, Bueter M (2014) The physiology underlying Roux-en-Y gastric bypass: a status report. Am J Physiol Regul Integr Comp Physiol 307(11):R1275–R1291CrossRef
40.
41.
Zurück zum Zitat Jackness C et al (2013) Very low-calorie diet mimics the early beneficial effect of Roux-en-Y gastric bypass on insulin sensitivity and beta-cell function in type 2 diabetic patients. Diabetes 62(9):3027–3032CrossRefPubMedPubMedCentral Jackness C et al (2013) Very low-calorie diet mimics the early beneficial effect of Roux-en-Y gastric bypass on insulin sensitivity and beta-cell function in type 2 diabetic patients. Diabetes 62(9):3027–3032CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Dutia R et al (2015) Temporal changes in bile acid levels and 12alpha-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond) 39:806–813 Dutia R et al (2015) Temporal changes in bile acid levels and 12alpha-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond) 39:806–813
43.
Zurück zum Zitat Erejuwa OO, Sulaiman SA, Ab Wahab MS (2014) Modulation of gut microbiota in the management of metabolic disorders: the prospects and challenges. Int J Mol Sci 15(3):4158–4188CrossRefPubMedPubMedCentral Erejuwa OO, Sulaiman SA, Ab Wahab MS (2014) Modulation of gut microbiota in the management of metabolic disorders: the prospects and challenges. Int J Mol Sci 15(3):4158–4188CrossRefPubMedPubMedCentral
45.
Zurück zum Zitat Jurowich CF et al (2013) Duodenal-jejunal bypass improves glycemia and decreases SGLT1-mediated glucose absorption in rats with streptozotocin-induced type 2 diabetes. Ann Surg 258(1):89–97CrossRefPubMed Jurowich CF et al (2013) Duodenal-jejunal bypass improves glycemia and decreases SGLT1-mediated glucose absorption in rats with streptozotocin-induced type 2 diabetes. Ann Surg 258(1):89–97CrossRefPubMed
46.
Zurück zum Zitat Saeidi N et al (2013) Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science 341(6144):406–410CrossRefPubMedPubMedCentral Saeidi N et al (2013) Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science 341(6144):406–410CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Service GJ et al (2005) Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med 353(3):249–254CrossRefPubMed Service GJ et al (2005) Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med 353(3):249–254CrossRefPubMed
48.
Zurück zum Zitat Reubi JC et al (2010) Glucagon-like peptide-1 (GLP-1) receptors are not overexpressed in pancreatic islets from patients with severe hyperinsulinaemic hypoglycaemia following gastric bypass. Diabetologia 53(12):2641–2645CrossRefPubMed Reubi JC et al (2010) Glucagon-like peptide-1 (GLP-1) receptors are not overexpressed in pancreatic islets from patients with severe hyperinsulinaemic hypoglycaemia following gastric bypass. Diabetologia 53(12):2641–2645CrossRefPubMed
49.
Zurück zum Zitat Meier JJ et al (2006) Hyperinsulinemic hypoglycemia after gastric bypass surgery is not accompanied by islet hyperplasia or increased beta-cell turnover. Diabetes Care 29(7):1554–1559CrossRefPubMed Meier JJ et al (2006) Hyperinsulinemic hypoglycemia after gastric bypass surgery is not accompanied by islet hyperplasia or increased beta-cell turnover. Diabetes Care 29(7):1554–1559CrossRefPubMed
50.
Zurück zum Zitat Aasheim ET et al (2012) Vitamin status after gastric bypass and lifestyle intervention: a comparative prospective study. Surg Obes Relat Dis 8(2):169–175CrossRefPubMed Aasheim ET et al (2012) Vitamin status after gastric bypass and lifestyle intervention: a comparative prospective study. Surg Obes Relat Dis 8(2):169–175CrossRefPubMed
51.
Zurück zum Zitat Vargas-Ruiz AG, Hernandez-Rivera G, Herrera MF (2008) Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg 18(3):288–293CrossRefPubMed Vargas-Ruiz AG, Hernandez-Rivera G, Herrera MF (2008) Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg 18(3):288–293CrossRefPubMed
52.
Zurück zum Zitat Carswell KA et al (2014) The effect of bariatric surgery on intestinal absorption and transit time. Obes Surg 24(5):796–805CrossRefPubMed Carswell KA et al (2014) The effect of bariatric surgery on intestinal absorption and transit time. Obes Surg 24(5):796–805CrossRefPubMed
53.
Zurück zum Zitat Kumar R et al (2011) Fat malabsorption and increased intestinal oxalate absorption are common after Roux-en-Y gastric bypass surgery. Surgery 149(5):654–661CrossRefPubMedPubMedCentral Kumar R et al (2011) Fat malabsorption and increased intestinal oxalate absorption are common after Roux-en-Y gastric bypass surgery. Surgery 149(5):654–661CrossRefPubMedPubMedCentral
54.
Zurück zum Zitat Odstrcil EA et al (2010) The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass. Am J Clin Nutr 92(4):704–713CrossRefPubMed Odstrcil EA et al (2010) The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass. Am J Clin Nutr 92(4):704–713CrossRefPubMed
55.
Zurück zum Zitat Pihlajamaki J et al (2010) Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding. Metabolism 59(6):866–872CrossRefPubMed Pihlajamaki J et al (2010) Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding. Metabolism 59(6):866–872CrossRefPubMed
56.
Zurück zum Zitat Li W et al (2014) Malabsorption plays a major role in the effects of the biliopancreatic diversion with duodenal switch on energy metabolism in rats. Surg Obes Relat Dis 11:356–366 Li W et al (2014) Malabsorption plays a major role in the effects of the biliopancreatic diversion with duodenal switch on energy metabolism in rats. Surg Obes Relat Dis 11:356–366
57.
Zurück zum Zitat Risstad H et al (2015) Five-year outcomes after laparoscopic gastric bypass and laparoscopic duodenal switch in patients with body mass index of 50 to 60: a randomized clinical trial. JAMA Surg 150(4):352–361CrossRefPubMed Risstad H et al (2015) Five-year outcomes after laparoscopic gastric bypass and laparoscopic duodenal switch in patients with body mass index of 50 to 60: a randomized clinical trial. JAMA Surg 150(4):352–361CrossRefPubMed
58.
Zurück zum Zitat Kenler HA, Brolin RE, Cody RP (1990) Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr 2(1):87–92 Kenler HA, Brolin RE, Cody RP (1990) Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr 2(1):87–92
59.
Zurück zum Zitat Laurenius A et al (2013) Decreased energy density and changes in food selection following Roux-en-Y gastric bypass. Eur J Clin Nutr 67(2):168–173CrossRefPubMed Laurenius A et al (2013) Decreased energy density and changes in food selection following Roux-en-Y gastric bypass. Eur J Clin Nutr 67(2):168–173CrossRefPubMed
60.
Zurück zum Zitat le Roux CW et al (2011) Gastric bypass reduces fat intake and preference. Am J Physiol Regul Integr Comp Physiol 301(4):R1057–R1066CrossRef le Roux CW et al (2011) Gastric bypass reduces fat intake and preference. Am J Physiol Regul Integr Comp Physiol 301(4):R1057–R1066CrossRef
61.
Zurück zum Zitat Miras AD et al (2012) Gastric bypass surgery for obesity decreases the reward value of a sweet-fat stimulus as assessed in a progressive ratio task. Am J Clin Nutr 96(3):467–473CrossRefPubMed Miras AD et al (2012) Gastric bypass surgery for obesity decreases the reward value of a sweet-fat stimulus as assessed in a progressive ratio task. Am J Clin Nutr 96(3):467–473CrossRefPubMed
62.
Zurück zum Zitat Olbers T et al (2006) Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg 244(5):715–722CrossRefPubMedPubMedCentral Olbers T et al (2006) Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg 244(5):715–722CrossRefPubMedPubMedCentral
63.
Zurück zum Zitat Scholtz S et al (2014) Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding. Gut 63(6):891–902CrossRefPubMedPubMedCentral Scholtz S et al (2014) Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding. Gut 63(6):891–902CrossRefPubMedPubMedCentral
64.
Zurück zum Zitat Mallory GN, Macgregor AM, Rand CS (1996) The influence of dumping on weight loss after gastric restrictive surgery for morbid obesity. Obes Surg 6(6):474–478CrossRefPubMed Mallory GN, Macgregor AM, Rand CS (1996) The influence of dumping on weight loss after gastric restrictive surgery for morbid obesity. Obes Surg 6(6):474–478CrossRefPubMed
65.
Zurück zum Zitat Baumann T et al (2011) Time-resolved MRI after ingestion of liquids reveals motility changes after laparoscopic sleeve gastrectomy – preliminary results. Obes Surg 21(1):95–101CrossRefPubMed Baumann T et al (2011) Time-resolved MRI after ingestion of liquids reveals motility changes after laparoscopic sleeve gastrectomy – preliminary results. Obes Surg 21(1):95–101CrossRefPubMed
66.
Zurück zum Zitat Braghetto I et al (2009) Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg 19(11):1515–1521CrossRefPubMed Braghetto I et al (2009) Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg 19(11):1515–1521CrossRefPubMed
67.
Zurück zum Zitat Melissas J et al (2008) Sleeve gastrectomy – a „food limiting“ operation. Obes Surg 18(10):1251–1256CrossRefPubMed Melissas J et al (2008) Sleeve gastrectomy – a „food limiting“ operation. Obes Surg 18(10):1251–1256CrossRefPubMed
68.
69.
Zurück zum Zitat Pomerri F et al (2011) Laparoscopic sleeve gastrectomy – radiological assessment of fundus size and sleeve voiding. Obes Surg 21(7):858–863CrossRefPubMed Pomerri F et al (2011) Laparoscopic sleeve gastrectomy – radiological assessment of fundus size and sleeve voiding. Obes Surg 21(7):858–863CrossRefPubMed
70.
Zurück zum Zitat Shah S et al (2010) 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. Surg Obes Relat Dis 6(2):152–157CrossRefPubMed Shah S et al (2010) 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. Surg Obes Relat Dis 6(2):152–157CrossRefPubMed
71.
Zurück zum Zitat Madsbad S, Holst JJ (2014) GLP-1 as a mediator in the remission of type 2 diabetes after gastric bypass and sleeve gastrectomy surgery. Diabetes 63(10):3172–3174CrossRefPubMed Madsbad S, Holst JJ (2014) GLP-1 as a mediator in the remission of type 2 diabetes after gastric bypass and sleeve gastrectomy surgery. Diabetes 63(10):3172–3174CrossRefPubMed
73.
Zurück zum Zitat Bernstine H et al (2009) Gastric emptying is not affected by sleeve gastrectomy – scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg 19(3):293–298CrossRefPubMed Bernstine H et al (2009) Gastric emptying is not affected by sleeve gastrectomy – scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg 19(3):293–298CrossRefPubMed
74.
Zurück zum Zitat Padoin AV et al (2009) Obese patients with type 2 diabetes submitted to banded gastric bypass: greater incidence of dumping syndrome. Obes Surg 19(11):1481–1484CrossRefPubMed Padoin AV et al (2009) Obese patients with type 2 diabetes submitted to banded gastric bypass: greater incidence of dumping syndrome. Obes Surg 19(11):1481–1484CrossRefPubMed
75.
Zurück zum Zitat Schauer PR et al (2014) Bariatric surgery versus intensive medical therapy for diabetes – 3-year outcomes. N Engl J Med 370(21):2002–2013CrossRefPubMed Schauer PR et al (2014) Bariatric surgery versus intensive medical therapy for diabetes – 3-year outcomes. N Engl J Med 370(21):2002–2013CrossRefPubMed
76.
Zurück zum Zitat Sigstad H (1970) A clinical diagnostic index in the diagnosis of the dumping syndrome. Changes in plasma volume and blood sugar after a test meal. Acta Med Scand 188(6):479–486PubMed Sigstad H (1970) A clinical diagnostic index in the diagnosis of the dumping syndrome. Changes in plasma volume and blood sugar after a test meal. Acta Med Scand 188(6):479–486PubMed
77.
Zurück zum Zitat Laurenius A et al (2013) Dumping syndrome following gastric bypass: validation of the dumping symptom rating scale. Obes Surg 23(6):740–755CrossRefPubMed Laurenius A et al (2013) Dumping syndrome following gastric bypass: validation of the dumping symptom rating scale. Obes Surg 23(6):740–755CrossRefPubMed
78.
Zurück zum Zitat Laurenius A et al (2014) More symptoms but similar blood glucose curve after oral carbohydrate provocation in patients with a history of hypoglycemia-like symptoms compared to asymptomatic patients after Roux-en-Y gastric bypass. Surg Obes Relat Dis 10(6):1047–1054CrossRefPubMed Laurenius A et al (2014) More symptoms but similar blood glucose curve after oral carbohydrate provocation in patients with a history of hypoglycemia-like symptoms compared to asymptomatic patients after Roux-en-Y gastric bypass. Surg Obes Relat Dis 10(6):1047–1054CrossRefPubMed
79.
Zurück zum Zitat Hanaire H et al (2010) Usefulness of continuous glucose monitoring for the diagnosis of hypoglycemia after a gastric bypass in a patient previously treated for type 2 diabetes. Obes Surg 20(1):126–129CrossRefPubMed Hanaire H et al (2010) Usefulness of continuous glucose monitoring for the diagnosis of hypoglycemia after a gastric bypass in a patient previously treated for type 2 diabetes. Obes Surg 20(1):126–129CrossRefPubMed
80.
Zurück zum Zitat Zagury L et al (2004) Insulinoma misdiagnosed as dumping syndrome after bariatric surgery. Obes Surg 14(1):120–123CrossRefPubMed Zagury L et al (2004) Insulinoma misdiagnosed as dumping syndrome after bariatric surgery. Obes Surg 14(1):120–123CrossRefPubMed
81.
Zurück zum Zitat Andersen JR, Holtug K, Uhrenholt A (1989) Trial of pectin-enriched muffins in patients with severe dumping syndrome after gastric resection. Observations on symptoms and gastric emptying pattern. Acta Chir Scand 155(1):39–41CrossRefPubMed Andersen JR, Holtug K, Uhrenholt A (1989) Trial of pectin-enriched muffins in patients with severe dumping syndrome after gastric resection. Observations on symptoms and gastric emptying pattern. Acta Chir Scand 155(1):39–41CrossRefPubMed
82.
Zurück zum Zitat Harju E, Larmi TK (1983) Efficacy of guar gum in preventing the dumping syndrome. JPEN J Parenter Enteral Nutr 7(5):470–472CrossRefPubMed Harju E, Larmi TK (1983) Efficacy of guar gum in preventing the dumping syndrome. JPEN J Parenter Enteral Nutr 7(5):470–472CrossRefPubMed
83.
Zurück zum Zitat Jenkins DJ et al (1977) Effect of dietary fiber on complications of gastric surgery: prevention of postprandial hypoglycemia by pectin. Gastroenterology 73(2):215–217PubMed Jenkins DJ et al (1977) Effect of dietary fiber on complications of gastric surgery: prevention of postprandial hypoglycemia by pectin. Gastroenterology 73(2):215–217PubMed
84.
Zurück zum Zitat Leeds AR et al (1981) Pectin in the dumping syndrome: reduction of symptoms and plasma volume changes. Lancet 1(8229):1075–1078CrossRefPubMed Leeds AR et al (1981) Pectin in the dumping syndrome: reduction of symptoms and plasma volume changes. Lancet 1(8229):1075–1078CrossRefPubMed
85.
Zurück zum Zitat McLoughlin JC, Buchanan KD, Alam MJ (1979) A glycoside-hydrolase inhibitor in treatment of dumping syndrome. Lancet 2(8143):603–605CrossRefPubMed McLoughlin JC, Buchanan KD, Alam MJ (1979) A glycoside-hydrolase inhibitor in treatment of dumping syndrome. Lancet 2(8143):603–605CrossRefPubMed
86.
Zurück zum Zitat Moreira RO et al (2008) Post-prandial hypoglycemia after bariatric surgery: pharmacological treatment with verapamil and acarbose. Obes Surg 18(12):1618–1621CrossRefPubMed Moreira RO et al (2008) Post-prandial hypoglycemia after bariatric surgery: pharmacological treatment with verapamil and acarbose. Obes Surg 18(12):1618–1621CrossRefPubMed
87.
Zurück zum Zitat Ritz P et al (2012) Usefulness of acarbose and dietary modifications to limit glycemic variability following Roux-en-Y gastric bypass as assessed by continuous glucose monitoring. Diabetes Technol Ther 14(8):736–740CrossRefPubMed Ritz P et al (2012) Usefulness of acarbose and dietary modifications to limit glycemic variability following Roux-en-Y gastric bypass as assessed by continuous glucose monitoring. Diabetes Technol Ther 14(8):736–740CrossRefPubMed
88.
Zurück zum Zitat Valderas JP et al (2012) Acarbose improves hypoglycaemia following gastric bypass surgery without increasing glucagon-like peptide 1 levels. Obes Surg 22(4):582–586CrossRefPubMed Valderas JP et al (2012) Acarbose improves hypoglycaemia following gastric bypass surgery without increasing glucagon-like peptide 1 levels. Obes Surg 22(4):582–586CrossRefPubMed
90.
Zurück zum Zitat Nelson-Piercy C et al (1994) Effect of a new oral somatostatin analog (SDZ CO 611) on gastric emptying, mouth to cecum transit time, and pancreatic and gut hormone release in normal male subjects. J Clin Endocrinol Metab 78(2):329–336PubMed Nelson-Piercy C et al (1994) Effect of a new oral somatostatin analog (SDZ CO 611) on gastric emptying, mouth to cecum transit time, and pancreatic and gut hormone release in normal male subjects. J Clin Endocrinol Metab 78(2):329–336PubMed
91.
Zurück zum Zitat Parkinson C et al (2002) A comparison of the effects of pegvisomant and octreotide on glucose, insulin, gastrin, cholecystokinin, and pancreatic polypeptide responses to oral glucose and a standard mixed meal. J Clin Endocrinol Metab 87(4):1797–1804CrossRefPubMed Parkinson C et al (2002) A comparison of the effects of pegvisomant and octreotide on glucose, insulin, gastrin, cholecystokinin, and pancreatic polypeptide responses to oral glucose and a standard mixed meal. J Clin Endocrinol Metab 87(4):1797–1804CrossRefPubMed
92.
Zurück zum Zitat van Berge Henegouwen MI et al (1997) The effect of octreotide on gastric emptying at a dosage used to prevent complications after pancreatic surgery: a randomised, placebo controlled study in volunteers. Gut 41(6):758–762CrossRefPubMed van Berge Henegouwen MI et al (1997) The effect of octreotide on gastric emptying at a dosage used to prevent complications after pancreatic surgery: a randomised, placebo controlled study in volunteers. Gut 41(6):758–762CrossRefPubMed
93.
Zurück zum Zitat Penning C, Vecht J, Masclee AA (2005) Efficacy of depot long-acting release octreotide therapy in severe dumping syndrome. Aliment Pharmacol Ther 22(10):963–969CrossRefPubMed Penning C, Vecht J, Masclee AA (2005) Efficacy of depot long-acting release octreotide therapy in severe dumping syndrome. Aliment Pharmacol Ther 22(10):963–969CrossRefPubMed
94.
Zurück zum Zitat Arts J et al (2009) Efficacy of the long-acting repeatable formulation of the somatostatin analogue octreotide in postoperative dumping. Clin Gastroenterol Hepatol 7(4):432–437CrossRefPubMed Arts J et al (2009) Efficacy of the long-acting repeatable formulation of the somatostatin analogue octreotide in postoperative dumping. Clin Gastroenterol Hepatol 7(4):432–437CrossRefPubMed
95.
Zurück zum Zitat Deloose E et al (2014) A pilot study of the effects of the somatostatin analog pasireotide in postoperative dumping syndrome. Neurogastroenterol Motil 26(6):803–809CrossRefPubMed Deloose E et al (2014) A pilot study of the effects of the somatostatin analog pasireotide in postoperative dumping syndrome. Neurogastroenterol Motil 26(6):803–809CrossRefPubMed
96.
Zurück zum Zitat Hamdan K, Somers S, Chand M (2011) Management of late postoperative complications of bariatric surgery. Br J Surg 98(10):1345–1355CrossRefPubMed Hamdan K, Somers S, Chand M (2011) Management of late postoperative complications of bariatric surgery. Br J Surg 98(10):1345–1355CrossRefPubMed
97.
Zurück zum Zitat Jurowich C, Germer CT, Seyfried F, Thalheimer A (2012) Metabolische Chirurgie. Chirurg 83(6):583–598. doi:10.1007/s00104-011-2239-9. (Quiz 599–600) Jurowich C, Germer CT, Seyfried F, Thalheimer A (2012) Metabolische Chirurgie. Chirurg 83(6):583–598. doi:10.1007/s00104-011-2239-9. (Quiz 599–600)
Metadaten
Titel
Dumping-Syndrom
Diagnostik und Therapieoptionen
verfasst von
Dr. F. Seyfried
A. Wierlemann
M. Bala
M. Fassnacht
C. Jurowich
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Chirurgie / Ausgabe 9/2015
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-015-0047-3

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