Farise Yılmaz1, Gonca Kara Gedik1, Hasan Onner2 and Huseyin Yılmaz3*
1Department of Nuclear Medicine, Selcuk University Medical Faculty, Turkey
2Health Science University Turkey, Turkey
3Department of General Surgery, Selcuk University Medical Faculty, Turkey
Aim and Scope: Laparoscopic Sleeve Gastrectomy (LSG) technique has been the most commonly used surgical treatment approach in the treatment of obesity in recent years. However, there is no consensus among surgeons regarding whether the antrum should be preserved or not. On the other hand, post-meal intolerance (nausea, vomiting, etc.) that develops in patients after surgery seriously affects the quality of life. We investigated the relationship between the antrum resection margin and postoperative symptoms. We also examined the findings of Gastric Emptying Scintigraphy (GES) such as Gastroesophageal Reflux (GER) and gastric emptying half-time. Materials and Methods: Patients who underwent LSG between January 2017 and December 2018 were included in this prospective study. Study participants were divided into Antrum Resection (AR) and Antrum Preservation (AP) groups based on the antral resection margin lengths. Gastric emptying half-time for liquids was assessed by GES postoperatively. Quantitative analysis was performed for calculating gastric emptying half-time and visual analysis was undertaken for evaluation of the presence of GER. The patients were classified as symptomatic and asymptomatic according to the presence of nausea and vomiting. Also, patients were classified according to GER findings in GES. On the other hand, GES findings were compared with a control group of 20 people who received GES for other reasons. Results: A total of 60 patients (49 females, 11 males; mean age: 40.3 ± 20.1) included. 35 patients had an antral resection margin of 2 cm (antrum resection-AR group) while 25 patients had an antral resection margin of 4 cm (antrum preservation-AP group) from the pylorus. The mean result of gastric emptying half-time was calculated as 27.63 ± 10.98 min which was shorter than the result of the control group (54.35 ± 24.31 min). The difference was statistically significant (p=0.0001). However, no difference was found between the two different surgical techniques in terms of postoperative symptoms, gastric emptying half-time, and development of GER. Discussion: In conclusion, the duration of gastric emptying for liquid in patients who underwent LSG surgery decreases. Postoperative symptoms such as nausea, vomiting, and presence of GER, seem to be related neither to the LSG techniques nor the duration of liquid gastric emptying halftime.
Yılmaz F, Gedik GK, Onner H, Yılmaz H. The Relationship of Gastric Reflux and Scintigraphy Following Sleeve Gastrectomy. Clin Surg. 2021; 6: 3347..