Gastric emptying of semisolids and pouch motility following laparoscopic adjustable gastric banding

Background: Laparoscopic adjustable gastric banding (LAGB) has been popularized as an effective, safe, minimally invasive surgical technique for the treatment of morbid obesity. We performed a pilot study to evaluate gastric emptying of semisolid meals and antral motility following LAGB. Methods: Gastric emptying half-time was compared in normal volunteers and morbidly obese patients before and 6-12 months after LAGB using sulfur colloid-labeled semisolid meals. Results: There was no difference in mean age between groups. Women were prevalent in the group of obese patients. BMI was higher in patients before surgery (p<0.001). Patients following LAGB demonstrated prolonged gastric pouch emptying (T1/2=36.6 ±9.8 min) compared to subjects without surgery (23.8±4.7 min) and healthy volunteers (22.8±6.8 min; p<0.001). Similar gastric contractility was found all groups (3.3±0.4; p=0.968). No cases of band slippage or pouch dilatation were observed during mean follow-up of 11.4 months. Conclusions: A standard normal gastric pouch emptying rate of semisolids in asymptomatic patients after LAGB was established. Postoperative prolongation of gastric emptying is a matter of mechanical delay without gastric pouch denervation. This study provides a first step of future functional evaluation of complications following this type of bariatric surgery.