Gastric Emptying and Postprandial PYY Response After Biliopancreatic Diversion with Duodenal Switch
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jakob Hedberg & Hans Hedenstrِm & F. Anders Karlsson & Britt Edén-Engstrِm & Magnus Sundbom
- چاپ و سال / کشور: 2010
Description
Background Super-obesity (BMI>50) is increasing rapidly. We use the biliopancreatic diversion with duodenal switch (BPD-DS) as one option in this patient category. The aim of the present study was to investigate the emptying of the gastric tube, PYY levels and dumping symptoms after BPD-DS. Methods Emptying of the gastric tube was investigated with scintigraphy after an overnight fast. Twenty patients (median age 43 years, BMI 31.1 kg/m2) having undergone BPD-DS in median 3.5 years previously were included in the scintigraphic study. A technetium-labelled omelette was ingested and scintigraphic evaluation of gastric emptying was undertaken. Ten of the patients also underwent PYY measurements after a standardised meal and were compared to nine non-operated age-matched normal weight controls, both in the fasting state and after the test meal. Frequency of dumping symptoms was evaluated in all patients. Results The half-emptying time was 28±16 min. Lag phase was present in 30% of the patients. PYY levels were significantly higher in BPD-DS patients as compared to controls both in the fasting state (p<0.001) and after the test meal (p<0.001). Dumping symptoms were scarce and occurred in 17 of the 20 patients only few times yearly or less. Conclusions Although the pylorus is preserved in BPD-DS, the stomach emptying is faster than in non-operated subjects. PYY levels are elevated in the fasting state after BPD-DS and a marked response to a test meal is seen, likely due to the rapid stimulation of intraluminal nutrients in the distal ileum. In spite of this, dumping symptoms are uncommon.
OBES SURG (2011) 21:609–615 DOI 10.1007/s11695-010-0288-7 Published online: 23 September 2010
