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Changes in Satiety, Supra- and Infraband Transit, and Gastric Emptying Following Laparoscopic Adjustable Gastric Banding: A Prospective Follow-up Study

  • Physiology Research
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Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) induces and sustains weight loss, likely by activating the peripheral satiety mechanism. Recent data suggests that food is not retained above the optimally adjusted LAGB, suggesting that an alternate mechanism is inducing satiety. How transit and gastric emptying change following LAGB and correlate with satiety and weight loss have not been adequately defined.

Methods

LAGB patients underwent preoperative and 12-month follow-up nuclear scintigraphic assessments of esophageal transit and gastric emptying. A new technique that allowed the calculation of emptying times and transit through the supra- and infraband compartments was used to assess emptying and transit patterns postoperatively.

Results

Postoperatively, patients reported increased satiety both after a standard fast (3.7 ± 2.3 vs. 4.8 ± 2.1, p = 0.04) and following a standard semisolid meal (5.9 vs. 7.8 ± 1.7, p = 0.003). The mean percent excess weight loss was 48.5 ± 23.2%. The gastric emptying half-time (minutes) did not change significantly (63.5 ± 41.1 vs. 73.3 ± 26.8, p = 0.64). Semisolid transit into the infraband stomach was delayed briefly postoperatively in more patients (11 vs. 2, p = 0.001). There was minimal retention of the meal above the LAGB 2 min after commencing the gastric emptying study (median, 3%; interquartile range, 1.75–10); therefore, an emptying half-time of the supraband region could not be defined.

Conclusions

Weight loss, satiety, and early satiation following LAGB were associated with briefly delayed bolus transit into the infraband stomach. Retention of the semisolid meal above the LAGB was not observed. This is further evidence that suggests satiety develops following LAGB without physical restriction of meal size.

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Declaration

The Centre for Obesity Research and Education has received financial support from Allergan Inc., the manufacturer of the LAP-BAND, in the form of an unrestricted research grant. Paul Burton has received research funding from the National Health and Medical Research Council and the Royal Australasian College of Surgeons.

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Authors and Affiliations

  1. Centre for Obesity Research and Education (CORE), Monash University, The Alfred Hospital, Commercial Road Prahran, 3181, Melbourne, VIC, Australia

    Paul Robert Burton, Wendy A. Brown, Cheryl Laurie & Paul E. O’Brien

  2. Department of Nuclear Medicine, The Alfred Hospital, Melbourne, VIC, Australia

    Kenneth Yap, Matthew O’Donnell & Victor Kalff

  3. Department of Gastroenterology and University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia

    Geoff Hebbard

Authors
  1. Paul Robert Burton
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  2. Kenneth Yap
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  3. Wendy A. Brown
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  4. Cheryl Laurie
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  5. Matthew O’Donnell
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  6. Geoff Hebbard
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  7. Victor Kalff
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  8. Paul E. O’Brien
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Correspondence to Paul Robert Burton.

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Burton, P.R., Yap, K., Brown, W.A. et al. Changes in Satiety, Supra- and Infraband Transit, and Gastric Emptying Following Laparoscopic Adjustable Gastric Banding: A Prospective Follow-up Study. OBES SURG 21, 217–223 (2011). https://doi.org/10.1007/s11695-010-0312-y

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  • DOI: https://doi.org/10.1007/s11695-010-0312-y

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