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Tytuł:
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Effect of sleeve gastrectomy and Roux-en-Y gastric bypass on gastrointestinal physiology.
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Autorzy:
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Steenackers N; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
Vanuytsel T; Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
Augustijns P; Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
Deleus E; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium.
Deckers W; Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.
Deroose CM; Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.
Falony G; Institute, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium; Center for Microbiology, VIB, Leuven, Belgium.
Lannoo M; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium.
Mertens A; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
Mols R; Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
Vangoitsenhoven R; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
Wauters L; Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.
Van der Schueren B; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
Matthys C; Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium. Electronic address: .
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Źródło:
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European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V [Eur J Pharm Biopharm] 2023 Feb; Vol. 183, pp. 92-101. Date of Electronic Publication: 2023 Jan 02.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Amsterdam : Elsevier Science
Original Publication: Stuttgart : Wissenschaftliche Verlagsgesellschaft, c1991-
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MeSH Terms:
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Gastric Bypass*/methods
Obesity, Morbid*/surgery
Obesity, Morbid*/complications
Humans ; Cross-Sectional Studies ; Obesity/surgery ; Obesity/complications ; Gastrectomy/methods ; Bile Acids and Salts
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Contributed Indexing:
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Keywords: Bariatric surgery; Bile acids; Gastric emptying; Gastrointestinal pH; Gastrointestinal physiology; Gastrointestinal pressure; Gastrointestinal transit time; Roux-en-Y gastric bypass; Sleeve gastrectomy; Wireless motility capsule
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Substance Nomenclature:
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0 (Bile Acids and Salts)
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Entry Date(s):
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Date Created: 20230105 Date Completed: 20230131 Latest Revision: 20230202
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Update Code:
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20240105
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DOI:
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10.1016/j.ejpb.2022.12.018
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PMID:
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36603693
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Background: Knowledge regarding the gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass is urgently needed to understand, prevent and treat the nutritional and pharmacological complications of bariatric surgery.
Aim: To investigate the effect of sleeve gastrectomy and Roux-en-Y gastric bypass on gastrointestinal motility (e.g., transit and pressure), pH, and intestinal bile acid concentration.
Material and Methods: An exploratory cross-sectional study was performed in six participants living with obesity, six participants who underwent sleeve gastrectomy, and six participants who underwent Roux-en-Y gastric bypass. During the first visit, a wireless motility capsule (SmartPill©) was ingested after an overnight fast to measure gastrointestinal transit, pH, and pressure. During the second visit, a gastric emptying scintigraphy test of a nutritional drink labeled with 99m Tc-colloid by a dual-head SPECT gamma camera was performed to measure gastric emptying half-time (GET 1/2 ). During the third visit, two customized multiple lumen aspiration catheters were positioned to collect fasting and postprandial intestinal fluids to measure bile acid concentration.
Results: Immediate pouch emptying (P = 0.0007) and a trend for faster GET 1/2 (P = 0.09) were observed in both bariatric groups. There was a tendency for a shorter orocecal transit in participants with sleeve gastrectomy and Roux-en-Y gastric bypass (P = 0.08). The orocecal segment was characterized by a higher 25th percentile pH (P = 0.004) and a trend for a higher median pH in both bariatric groups (P = 0.07). Fasting total bile acid concentration was 7.5-fold higher in the common limb after Roux-en-Y gastric bypass (P < 0.0001) and 3.5-fold higher in the jejunum after sleeve gastrectomy (P = 0.009) compared to obesity. Postprandial bile acid concentration was 3-fold higher in the jejunum after sleeve gastrectomy (P = 0.0004) and 6.5-fold higher in the common limb after Roux-en-Y gastric bypass (P < 0.0001) compared to obesity.
Conclusion: The anatomical alterations of sleeve gastrectomy and Roux-en-Y gastric bypass have an important impact on gastrointestinal physiology. This data confirms changes in transit and pH and provides the first evidence for altered intraluminal bile acid concentration.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
