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- Title
Delayed Gastric Emptying After Sleeve Gastrectomy Is Associated with Poor Weight Loss.
- Authors
Wickremasinghe, Anagi Chethana; Johari, Yazmin; Laurie, Cheryl; Shaw, Kalai; Playfair, Julie; Beech, Paul; Yue, Helen; Becroft, Louise; Hebbard, Geoffrey; Yap, Kenneth S.; Brown, Wendy; Burton, Paul
- Abstract
Background: Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of weight loss remain unclear. We aimed to determine if there were specific esophago-gastric transit and emptying alterations associated with weight regain. Material and Methods: Participants greater than 12 months post-SG were categorized into optimal (n = 29) and poor weight loss (PWL) (n = 72). All patients underwent a liquid contrast barium swallow demonstrating normal post-surgical anatomy and a protocolized nuclear scintigraphy designed specifically to characterize gastric emptying following SG. Results: The %total weight loss in the optimal group was 26.2 ± 10.5 vs. 14.3 ± 8.8% in the PWL group (p = 0.001). Scintigraphy showed PWL had relatively increased gastric emptying half-time (GE 1/2t) 35 (IQR 23) min vs 19 (IQR 5.5) min (p = 0.001). The multivariate regressions delineated GE 1/2t as the best diagnostic measure for PWL (OR 1.16; CI 1.04–1.29, p-value 0.021). The probability of PWL increased by 16% for every 1-min increase above 21 min of GE 1/2t. A threshold of 21 min was found to have 88% sensitivity and 69% specificity predicting poor weight loss. Conclusion: Gastric emptying half-times greater than 21 min appear to reliably correlate with poor weight loss following SG. Additionally, further elevations above 21 min in emptying half-time increase the risk of poor weight loss. We have shown nuclear scintigraphy represents a simple and accurate diagnostic tool in patients who experience poor weight loss after SG, provided substantially altered reporting references in interpreting nuclear scintigraphy are applied.
- Subjects
WEIGHT loss; GASTRIC emptying; SLEEVE gastrectomy; RADIONUCLIDE imaging; SENSITIVITY &; specificity (Statistics)
- Publication
Obesity Surgery, 2022, Vol 32, Issue 12, p3922
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-022-06323-2