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Erschienen in: Langenbeck's Archives of Surgery 1/2020

20.01.2020 | Original Article

Sleeve gastrectomy for treatment of delayed gastric emptying—indications, technique, and results

verfasst von: Arielle Marian Lee, Karl-Hermann Fuchs, Gabor Varga, Wolfram Breithaupt, Kai Neki, Ryan Broderick, Santiago Horgan

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 1/2020

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Abstract

Introduction

Delayed gastric emptying (DGE) can be caused by gastric motility disorders such as gastroparesis with idiopathic background, diabetic neuropathy, or postsurgical nerve damage. Currently, a variety of endoscopic and surgical treatment options are available. We noted clinical improvement of gastric emptying with reduction of the gastric fundus following both fundoplication and fundectomy. As a consequence, we explored the effect of sleeve gastrectomy on gastric emptying. The focus of this paper is to investigate the role of laparoscopic sleeve gastrectomy (LSG) in the treatment of gastroparesis.

Methods

Patients with symptoms suggestive of gastroparesis received diagnostic work-up (gastric emptying scintigraphy and/or Radiographic Barium-Sandwich Emptying studies). Patients with fundic emptying problems and moderate gastric dilation were selected for a LSG. All perioperative parameters were documented regarding patients characteristics, complications, and outcomes expressed as symptoms and quality of life (GIQLI gastrointestinal quality of life index). Assessment of DGE: Barium Emptying Radigraphy Index (BERI) 0–5.

Results

From 122 patients with gastroparesis, 19 patients were selected for LSG (mean age 54 years (23–68); 10 males/9 females. Morbidity 2/19; no mortality; follow-up mean 24 months (12–60); preop/postop: BERI: 2, 31/1, 27 (p < 0.01); we noted significant improvement of the quality of life (preoperative GIQLI 78 (44–89)) to postoperative values of 114 (range 87–120) (p < 0.0001). Preoperative median BMI of these 19 patients was 24 [1–10], which was not significantly changed in the 15 patients at > 1 year follow-up with 23 [1–8]. Postoperative recurrence of DGE occurred in 3 patients who were reoperated after >1 year follow-up.

Conclusion

LSG is a potential surgical treatment option for selected patients with gastroparesis and fundic emptying problems.
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Metadaten
Titel
Sleeve gastrectomy for treatment of delayed gastric emptying—indications, technique, and results
verfasst von
Arielle Marian Lee
Karl-Hermann Fuchs
Gabor Varga
Wolfram Breithaupt
Kai Neki
Ryan Broderick
Santiago Horgan
Publikationsdatum
20.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 1/2020
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-020-01856-5

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