Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility

Objective. Laparoscopic sleeve gastrectomy (LSG) was considered mainly as a restrictive procedure due to anatomic alterations in the upper gastrointestinal tract. Additionally, due to neurohormonal alterations, LSG modifies the gastrointestinal motility, which controls appetite and feeling of satiet...

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Main Authors: Eleni Sioka, George Tzovaras, Konstantinos Perivoliotis, Vissarion Bakalis, Eleni Zachari, Dimitrios Magouliotis, Vassiliki Tassiopoulou, Spyridon Potamianos, Andreas Kapsoritakis, Antigoni Poultsidi, Konstantinos Tepetes, Constantine Chatzitheofilou, Dimitris Zacharoulis
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/4135813
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author Eleni Sioka
George Tzovaras
Konstantinos Perivoliotis
Vissarion Bakalis
Eleni Zachari
Dimitrios Magouliotis
Vassiliki Tassiopoulou
Spyridon Potamianos
Andreas Kapsoritakis
Antigoni Poultsidi
Konstantinos Tepetes
Constantine Chatzitheofilou
Dimitris Zacharoulis
author_facet Eleni Sioka
George Tzovaras
Konstantinos Perivoliotis
Vissarion Bakalis
Eleni Zachari
Dimitrios Magouliotis
Vassiliki Tassiopoulou
Spyridon Potamianos
Andreas Kapsoritakis
Antigoni Poultsidi
Konstantinos Tepetes
Constantine Chatzitheofilou
Dimitris Zacharoulis
author_sort Eleni Sioka
collection DOAJ
description Objective. Laparoscopic sleeve gastrectomy (LSG) was considered mainly as a restrictive procedure due to anatomic alterations in the upper gastrointestinal tract. Additionally, due to neurohormonal alterations, LSG modifies the gastrointestinal motility, which controls appetite and feeling of satiety. Aim. The aim of the study was to review the impact of laparoscopic sleeve gastrectomy on gastrointestinal motility. Material and Methods. A search of the medical literature was undertaken in Pubmed, Web of Science, and Cochrane library. Esophageal, gastric, bowel motility were assessed separately. Results. Nine studies assessed esophageal motility. The data remain debatable attributing to the heterogeneity of follow-up timing, surgical technique, bougie size, and distance from pylorus. The stomach motility was assessed in eighteen studies. Functionally, the sleeve was divided into a passive sleeve and an accelerated antrum. All scintigraphic studies revealed accelerated gastric emptying after LSG except of one. Patients demonstrated a rapid gastroduodenal transit time. The resection of the gastric pacemaker had as a consequence aberrant distal ectopic pacemaking or bioelectrical quiescence after LSG. The bowel motility was the least studied. Small bowel transit time was reduced; opposite to that the initiation of cecal filling and the ileocecal valve transit was delayed. Conclusion. Laparoscopic sleeve gastrectomy has impacts on gastrointestinal motility. The data remain debatable for esophageal motility. Stomach and small bowel motility were accelerated, while the initiation of cecal filling and the ileocecal valve transit was delayed. Further pathophysiological studies are needed to evaluate the correlation of motility data with clinical symptoms.
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spelling doaj-art-e9a74bd393b348ffbd3e4e45c8f6df5b2025-08-20T03:26:34ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/41358134135813Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal MotilityEleni Sioka0George Tzovaras1Konstantinos Perivoliotis2Vissarion Bakalis3Eleni Zachari4Dimitrios Magouliotis5Vassiliki Tassiopoulou6Spyridon Potamianos7Andreas Kapsoritakis8Antigoni Poultsidi9Konstantinos Tepetes10Constantine Chatzitheofilou11Dimitris Zacharoulis12Department of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceDepartment of Surgery, University Hospital of Larissa, Larissa, GreeceObjective. Laparoscopic sleeve gastrectomy (LSG) was considered mainly as a restrictive procedure due to anatomic alterations in the upper gastrointestinal tract. Additionally, due to neurohormonal alterations, LSG modifies the gastrointestinal motility, which controls appetite and feeling of satiety. Aim. The aim of the study was to review the impact of laparoscopic sleeve gastrectomy on gastrointestinal motility. Material and Methods. A search of the medical literature was undertaken in Pubmed, Web of Science, and Cochrane library. Esophageal, gastric, bowel motility were assessed separately. Results. Nine studies assessed esophageal motility. The data remain debatable attributing to the heterogeneity of follow-up timing, surgical technique, bougie size, and distance from pylorus. The stomach motility was assessed in eighteen studies. Functionally, the sleeve was divided into a passive sleeve and an accelerated antrum. All scintigraphic studies revealed accelerated gastric emptying after LSG except of one. Patients demonstrated a rapid gastroduodenal transit time. The resection of the gastric pacemaker had as a consequence aberrant distal ectopic pacemaking or bioelectrical quiescence after LSG. The bowel motility was the least studied. Small bowel transit time was reduced; opposite to that the initiation of cecal filling and the ileocecal valve transit was delayed. Conclusion. Laparoscopic sleeve gastrectomy has impacts on gastrointestinal motility. The data remain debatable for esophageal motility. Stomach and small bowel motility were accelerated, while the initiation of cecal filling and the ileocecal valve transit was delayed. Further pathophysiological studies are needed to evaluate the correlation of motility data with clinical symptoms.http://dx.doi.org/10.1155/2018/4135813
spellingShingle Eleni Sioka
George Tzovaras
Konstantinos Perivoliotis
Vissarion Bakalis
Eleni Zachari
Dimitrios Magouliotis
Vassiliki Tassiopoulou
Spyridon Potamianos
Andreas Kapsoritakis
Antigoni Poultsidi
Konstantinos Tepetes
Constantine Chatzitheofilou
Dimitris Zacharoulis
Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility
Gastroenterology Research and Practice
title Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility
title_full Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility
title_fullStr Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility
title_full_unstemmed Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility
title_short Impact of Laparoscopic Sleeve Gastrectomy on Gastrointestinal Motility
title_sort impact of laparoscopic sleeve gastrectomy on gastrointestinal motility
url http://dx.doi.org/10.1155/2018/4135813
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