Evaluation of Postprandial Symptoms in Two Different Laparoscopic Sleeve Gastrectomy Techniques Using Gastric Emptying Scintigraphy

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) is a frequently used procedure in the surgical treatment of obesity in recent years. However,  surgeons have different opinions regarding the distance from the antrum to the pylorus. In addition, postprandial symptoms significantly affect the  overall quality of life.

 Aim: Therefore, this study aimed to understand the relationship between postprandial symptoms with gastric emptying time and surgical procedures.

Patients and Methods: Sixty patients who underwent LSG surgery were analyzed retrospectively and divided into two groups: antrum preserved (AP)  and antrum resected (AR). The antral resection margin was 2 cm from the pylorus in 35 patients (AR group) and 6 cm in 25 patients (AP group). Semisolid  gastric emptying scintigraphy (GES) was performed prospectively in both groups. Postprandial symptoms were standardized with a questionnaire. The  relationship of symptoms with a half time of gastric emptying (GE T½), retention percentage at 30 and 60 minutes, lag phase, body mass index (BMI), and  a decline in excess weight (% EWL), and antrum resection were investigated. The obtained results were compared between the two groups and with the  control group.

Results: The study group comprised 60 patients (49 F/11 M, mean age: 40.3 ± 20.1 years, BMI 31.6 ± 8.1 kg/ m²). The half-time of gastric  emptying in the AR and AP groups (28.00 min ± 9.58, 28.24 min ± 11.90, respectively), percentage gastric retention at 30 and 60 minutes in the AR and AP  groups (30 minutes: %44.37 ± 17.88, %40.52 ± 14.56 and 60 minutes: 17 ± 8.9, 19 ± 3.1) was significantly different compared with the control group, but  no significant difference was observed between the study groups. In addition, there was no statistically significant difference between the AR and AP groups in postprandial symptom scores >9 (68.6%, 60%, P = 0.681), GER (77.1%, 64%, P = 0.253), and postoperative BMI (p = .397), % EWL (p = .975), and T  lag phase (p = .332).

Conclusions: In our study, the postprandial symptoms were not affected between two different surgical procedures in LSG.