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

Obesity Surgery
P BjörklundLars Fändriks

Abstract

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. 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. 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. A successful RYGBP is associated with MMC in the Roux limb du...Continue Reading

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Jul 2, 2015·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·F SeyfriedC Jurowich
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