Manometry of the Upper Gut Following Roux-en-Y Gastric Bypass Indicates That the Gastric Pouch and Roux Limb Act as a ... View Full Text


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Article Info

DATE

2015-10

AUTHORS

Per Björklund, Hans Lönroth, Lars Fändriks

ABSTRACT

BACKGROUND: The motility of the upper gut after Roux-en-Y gastric bypass (RYGBP) is underexplored. We aimed to investigate the oesophago-gastro-Roux limb motor activity during fasting and after food intake. METHODS: Eighteen morbidly obese patients were examined at least 2 years after RYGBP. A high-resolution manometry catheter was positioned to straddle the oesophagogastric junction, the gastric pouch and the proximal Roux limb using transmucosal potential difference measurements. Three patients with vertical banded gastroplasty (VBG) were also studied. RESULTS: During the fasting state, the gastric pouch had low or no activity whereas the Roux limb exhibited regular migrating motility complexes (MMCs) being initiated just distal to gastroenteroanastomosis. Median cycle duration was 72 min, and the median propagating velocity of the phase III MMC phase was 2.7 cm/min (n = 8). When patients were asked to eat until they felt comfortably full, intraluminal pressure increased by 6 to 8 cmH₂O without any significant difference between gastric pouch and the Roux limb (n = 9). The increased intraluminal pressure following food intake correlated neither to weight loss nor to meal size or rate of eating. CONCLUSIONS: A successful RYGBP is associated with MMC in the Roux limb during fasting. The gastric pouch and the Roux limb behaved as a common cavity during food ingestion. Data do not support the hypothesis that the alimentary limb pressure in response to food intake influences either meal size or weight loss. More... »

PAGES

1833-1841

References to SciGraph publications

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  • 2014-05. Roux-en-Y Limb Motility after Total Gastrectomy in JOURNAL OF GASTROINTESTINAL SURGERY
  • 2007-08. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass in SURGICAL ENDOSCOPY
  • 1992-04. Roux-limb motility after total gastrectomy and Roux-en-Y anastomosis in patients with zollinger-ellison syndrome in DIGESTIVE DISEASES AND SCIENCES
  • 1994-08. Motility Disorders after Roux-en-Y Gastrojejunostomy in OBESITY SURGERY
  • 2009-01. The Effect of Stoma Size on Weight Loss After Laparoscopic Gastric Bypass Surgery: Results of a Blinded Randomized Controlled Trial in OBESITY SURGERY
  • 2012-05. The migrating motor complex: control mechanisms and its role in health and disease in NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
  • 2012-03. Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass in INTERNATIONAL JOURNAL OF OBESITY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11695-015-1639-1

    DOI

    http://dx.doi.org/10.1007/s11695-015-1639-1

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/25736230


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    54 schema:description BACKGROUND: The motility of the upper gut after Roux-en-Y gastric bypass (RYGBP) is underexplored. We aimed to investigate the oesophago-gastro-Roux limb motor activity during fasting and after food intake. METHODS: Eighteen morbidly obese patients were examined at least 2 years after RYGBP. A high-resolution manometry catheter was positioned to straddle the oesophagogastric junction, the gastric pouch and the proximal Roux limb using transmucosal potential difference measurements. Three patients with vertical banded gastroplasty (VBG) were also studied. RESULTS: During the fasting state, the gastric pouch had low or no activity whereas the Roux limb exhibited regular migrating motility complexes (MMCs) being initiated just distal to gastroenteroanastomosis. Median cycle duration was 72 min, and the median propagating velocity of the phase III MMC phase was 2.7 cm/min (n = 8). When patients were asked to eat until they felt comfortably full, intraluminal pressure increased by 6 to 8 cmH₂O without any significant difference between gastric pouch and the Roux limb (n = 9). The increased intraluminal pressure following food intake correlated neither to weight loss nor to meal size or rate of eating. CONCLUSIONS: A successful RYGBP is associated with MMC in the Roux limb during fasting. The gastric pouch and the Roux limb behaved as a common cavity during food ingestion. Data do not support the hypothesis that the alimentary limb pressure in response to food intake influences either meal size or weight loss.
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