Obesity Surgery

, Volume 19, Issue 3, pp 287–292 | Cite as

Weight Loss After Laparoscopic Adjustable Gastric Banding is not Caused by Altered Gastric Emptying

  • J. R. de JongEmail author
  • B. van Ramshorst
  • H. G. Gooszen
  • A. J. P. M. Smout
  • M. M. C. Tiel-Van Buul
Research Article



In order to know the role of gastric emptying in the mechanism of weight loss and early satiety after a restrictive surgical procedure for treatment of morbid obesity, a consecutive series of patients were scintigraphically investigated before and after laparoscopic adjustable gastric banding.


Sixteen patients undergoing laparoscopic adjustable gastric banding underwent preoperatively, and at 6 months postoperatively, a gastric emptying study (solid meal and single isotope). Esophageal retention time, lag phase, peak activity time, gastric emptying rate, fundus emptying rate, and weight loss were recorded. Upper GI symptom assessment was carried out by using a standardized questionnaire. Gastric emptying parameters were correlated with the upper GI symptoms.


Gastric band placement showed no significant influence on postoperative gastric emptying rate [median % (interquartile range): 42 (23.3–59) preoperatively vs 38 (31–71) postoperatively and fundus emptying rate: 59(37–91) preoperatively vs 70 (53–89) postoperatively]; however, an increase in early satiety was found. Neither gastric emptying rate nor fundus emptying rate showed a relation with early satiety or weight loss. Furthermore, no correlation was found between early satiety and lag phase, esophageal retention time, start of activity, and peak activity time in proximal stomach.


Laparoscopic adjustable gastric banding seems not to affect gastric emptying. Neither a relation between postoperative gastric emptying rate and weight loss nor between early satiety and weight loss was found. Therefore, it is unlikely that gastric emptying plays a role in the mechanism of weight loss following laparoscopic adjustable gastric banding.


Obesity Gastric banding Gastric emptying 


  1. 1.
    Horowitz M, Collins PJ, Chatterton BE, et al. Gastric emptying after gastroplasty for morbid obesity. Br J Surg 1984;71:435–7.CrossRefGoogle Scholar
  2. 2.
    Gannon MX, Pears DJ, Chandler ST, et al. The effect of gastric partitioning on gastric emptying in morbidly obese patients. Br J Surg 1985;72:952–4.CrossRefGoogle Scholar
  3. 3.
    Kral JG, Gortz L, Hermansson G, et al. Gastroplasty for obesity:long term weight loss improved by vagotomy. World J Surg 1993;17:75–9.CrossRefGoogle Scholar
  4. 4.
    Villar HV, Wangenteen SL, Burks TF, et al. Mechanism of satiety and gastric emptying after gastric partitioning and bypass. Surgery 1981;90:229–36.PubMedGoogle Scholar
  5. 5.
    Naslund I, Beckman KW. Gastric emptying rate after gastric bypass and gastroplasty. Scand J Gastroenterol 1987;22:193–201.CrossRefGoogle Scholar
  6. 6.
    Andersen T, Pedersen BH, Henriksen JH, et al. Pouch emptying of solid foods after gastroplasty for morbid obesity. Scand J Gastroenterol 1985;20:1175–9.CrossRefGoogle Scholar
  7. 7.
    Mistiaen W, Vaneerdeweg W, Blockx P, et al. Gastric emptying rate measurement after vertical banded gastroplasty. Obes Surg 2000;10:245–9.CrossRefGoogle Scholar
  8. 8.
    Vezina WC, Grace DM, Chamberlain MJ, et al. Gastric emptying before and after transverse gastroplasty for morbid obesity. Clin Nucl Med 1986;11:308–12.CrossRefGoogle Scholar
  9. 9.
    Fischler B, Tack J, De Gucht V, et al. Heterogenity of symptom pattern, psychosocial factors, and pathophysiological mechanisms in severe functional dyspepsia. Gastroenterology 2003;124:903–10.CrossRefGoogle Scholar
  10. 10.
    Naslund E, King N, Mansten S, et al. Prandial subcutaneous injections of glucagon-like peptide-1 cause weight loss in obese human subjects. Br J Nutr 2004;91:439–46.CrossRefGoogle Scholar
  11. 11.
    Reda TK, Geliebter A, Pi-Sunyer FX. Amylin, food intake and obesity. Obes Res 2002;10:1087–9.CrossRefGoogle Scholar
  12. 12.
    Belachew M, Belva PH, Desaive C. Long-term results of laparoscopic adjustabe gastric banding for the treatment of morbid obesity. Obes Surg 2002;12:564–8.CrossRefGoogle Scholar
  13. 13.
    Collins PJ, Horowitz M, Cook DJ, et al. Gastric emptying in normal subjects a reproducibltechnique using a single scintillation camera and computer system. Gut 1983;24:1117–25.CrossRefGoogle Scholar
  14. 14.
    Ziesmann HA, Fahey FH, Atkins FB, et al. Standardization and quantification of radionuclide solid gastric-emptying studies. J Nucl Med 2004;45:760–4.Google Scholar
  15. 15.
    Hutson WR, Wald A. Obesity and weight reduction do not influence gastric emptying and antral motility. Am J Gastroenterol 1993;88:1405–9.PubMedGoogle Scholar
  16. 16.
    Wright RA, Krinsky S, Fleeman C, et al. Gastric emptying and obesity. Gastroenterology 1983;84:747–51.PubMedGoogle Scholar
  17. 17.
    Tosetti C, Corinaldesi R, Stanghellini V, et al. Gastric emptying of solids in morbid obesity. Int J Obes 1996;20:200–5.Google Scholar
  18. 18.
    Maddox A, Horowitz M, Wishart J, et al. Gastric and oesophageal emptying in in obesity. Scand J Gastroenterol 1989;24:593–8.CrossRefGoogle Scholar
  19. 19.
    Horowitz M, Collins PJ, Cook DJ, et al. Abnormalities of gastric emptying in obese patients. Int J Obes 1983;7:415–21.PubMedGoogle Scholar
  20. 20.
    Christian PE, Datz FL, Moore JG. Gastric emptying studies in the morbidly obese before and after gastroplasty. J Nucl Med 1986;27:1686–90.PubMedGoogle Scholar
  21. 21.
    Behrns KE, Soper NJ, Sarr MG, et al. Anatomic, motor and clinical assessment of vertical banded gastroplasty. Gastroenterology 1989;97:91–7.CrossRefGoogle Scholar
  22. 22.
    Horowitz M, Cook DJ, Collins PJ, et al. Measurements of gastric emptying after gastric bypas surgery using radionuclides. Br J Surg 1982;69:655–7.CrossRefGoogle Scholar
  23. 23.
    Brogna A, Ferrara R, Bucceri AM, et al. Gastric emptying rates of solid food in relation to body mass index: an ultrasonographic and scintigraphic study. Eur J Radiol 1998;27:258–63.CrossRefGoogle Scholar
  24. 24.
    Vu MK, Straathof JW, Arndt JW, et al. Motor and sensory function of the proximal stomach in reflux disease and after laparoscopic Nissen fundoplication. Am J Gastroenterol 1999;94:1481–89.CrossRefGoogle Scholar
  25. 25.
    Swanstrom L, Wayne R. Spectrum of gastrointestinal symptoms after laparoscopic fundoplication. Am J Surg 1994;167:538–41.CrossRefGoogle Scholar
  26. 26.
    Bais JE, Samsom M, Boudesteijn EAJ, et al. The impact of delayed gastric emptying on the outcome of antireflux surgery. Ann Surg 2001;234:139–46.CrossRefGoogle Scholar
  27. 27.
    Lindeboom MYA, Vu MK, Ringers J, et al. Function of the proximal stomach after partial versus complete laparoscopic fundoplication. Am J Gastroenterol 2003;98:284–90.CrossRefGoogle Scholar
  28. 28.
    Karim SS. Comparison of total vs partial fundoplication in the management of gastroesophageal disease. Am J Surg 1997;173:375–8.CrossRefGoogle Scholar
  29. 29.
    Lundell LR, Myers JC, Jamieson GG. Delayed gastric emptying and its relationship to symptoms of gas bloat after antireflux surgery. Eur J Surg 1994;160:161–6.PubMedGoogle Scholar
  30. 30.
    Mordes JP, el Lozy M, Herrera MG, et al. Effects of vagotomy with and without pyloroplasty on weight and food intake in rats. Am J Physiol 1979;236:61–6.Google Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • J. R. de Jong
    • 1
    Email author
  • B. van Ramshorst
    • 2
  • H. G. Gooszen
    • 3
  • A. J. P. M. Smout
    • 4
  • M. M. C. Tiel-Van Buul
    • 5
  1. 1.Department of SurgeryUniversity Medical CenterMaastrichtThe Netherlands
  2. 2.Department of SurgerySt. Antonius HospitalNieuwegeinThe Netherlands
  3. 3.Department of SurgeryUniversity Medical CenterUtrechtThe Netherlands
  4. 4.Department of GastroenterologyUniversity Medical CenterUtrechtThe Netherlands
  5. 5.Department of Nuclear MedicineSt. Antonius HospitalNieuwegeinThe Netherlands

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