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

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.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Björklund P,Lönroth H,Fändriks L

doi

10.1007/s11695-015-1639-1

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1833-41

issue

10

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-015-1639-1

journal_volume

25

pub_type

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