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Time-Resolved MRI After Ingestion of Liquids Reveals Motility Changes After Laparoscopic Sleeve Gastrectomy—Preliminary Results

Time-Resolved MRI After Ingestion of Liquids Reveals Motility Changes After Laparoscopic Sleeve Gastrectomy—Preliminary Results,10.1007/s11695-010-031

Time-Resolved MRI After Ingestion of Liquids Reveals Motility Changes After Laparoscopic Sleeve Gastrectomy—Preliminary Results   (Citations: 3)
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Background  Laparoscopic sleeve gastrectomy (LSG) is generally considered a restrictive procedure. However, studies with nuclear medicine techniques have demonstrated that gastric motility changes occur following LSG. These motility changes could represent complementary mechanisms of weight loss. Therefore, we analyzed the stomach motility before and after LSG by means of dynamic MRI. Methods   In this prospective pilot study, five female patients with a mean BMI of 51.6 kg/m2 underwent MRI 1 day before LSG and 6 days and 6 months after LSG. Dynamic steady-state free precession sequences were used to analyze the gastric motility after ingestion of 500 ml water with a temporal resolution of 0.86 s. Axial image stacks were also repeatedly acquired to determine the intragastric fluid volume over time. Results   Mean excess body mass index loss was 60.6% after 6 months. Dynamic analysis showed that antral propulsive peristalsis was preserved immediately after surgery and during follow-up, but fold speed increased significantly from 2.7 mm/s before LSG to 4.4 mm/s after 6 months. The sleeve itself remained without recognizable peristalsis in three patients and showed only uncoordinated or passive motion in two patients. Consequently, the fluid transport through the sleeve was markedly delayed, whereas the antrum showed accelerated propulsion with the emptying half-time decreasing from 16.5 min preoperatively to 7.9 min 6 months after surgery. Conclusions   Owing to the LSG procedure, the stomach is functionally divided into a sleeve without propulsive peristalsis and an accelerated antrum. Accelerated emptying seems to be caused by faster peristaltic folds.
Journal: Obesity Surgery - OBES SURG , vol. 21, no. 1, pp. 95-101, 2011
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    • ...We have read with interest the recent work on gastric motility evaluation in laparoscopic sleeve gastrectomy (LSG) by using magnetic resonance imaging (MRI) [1]...
    • ...This can explain the lower antral speed detected in our controls compared to that referred by the authors in the presurgical assessment [1, 2]. In this regard, we would like to warn the authors about the use of water that could produce a drawback in quantitative assessment due to influence of posture and gravity for liquids in gastric emptying [3, 4]; furthermore, steady-state imaging with a semisolid homogeneous food (like pudding) could ...

    Salvatore Francesco Carboneet al. Evaluation of Motility Changes after Laparoscopic Sleeve Gastrectomy U...

    • ...There is also a very recent radiological study using dynamic MRI evaluation of the motility of the gastric sleeve; preliminary results indicate accelerated emptying due to faster peristalsis in antrum [23]...

    George Tzovaraset al. Symptoms Suggestive of Dumping Syndrome After Provocation in Patients ...

    • ...In their study, nine patients after laparoscopic sleeve gastrectomy (LSG) were evaluated by MRI with a very similar imaging technique as used in our previous work [1]...
    • ...Fig. 1 Mean velocities of antral folds in five patients from [1] T. Baumann (*) Department of Radiology, University Hospital Freiburg, 79106 Freiburg, Germany e-mail: tobias.baumann@uniklinik-freiburg.de...

    Tobias Baumannet al. Reply to Evaluation of Motility Changes after Laparoscopic Sleeve Gast...

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