Transcutaneous Electrogastrography in the Perioperative Period in Patients Undergoing Laparoscopic Cholecystectomy and Laparoscopic Non-Adjustable Gastric Banding |
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Authors: | Robert Gürlich MD PhD Pavel Maruna MD PhD Roman Frasko MD |
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Institution: | (1) Institute of Pathological Physiology, 1st Medical Faculty, Charles University, Prague, Czech Republic;(2) 1st Department of Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic;(3) Institute of Pathological Physioloft, 1st Medical Faculty, Charles University |
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Abstract: | Background: Transcutaneous electrogastrography (EGG) is a non-invasive method of examination that allows monitoring of gastric
myoelectric activity. The goal of this prospective study was to describe changes in gastric motility in the early postoperative
period in extremely obese patients, who underwent planned surgery - Laparoscopic Non-Adjustable Gastric Banding (LNGB) and
to establish the specificity of observed differences for this intervention. Patients and Methods: Myoelectric gastric activity
was evaluated in the perioperative period in 20 extremely obese patients undergoing LNGB. The results of monitoring up to
+24 h after the intervention were compared to a group of 15 healthy volunteers, and to a group of 20 patients undergoing laparoscopic
cholecystectomy (LC). The recording was performed in both the patient and control groups 24 h before the operation and +5
h, +24 h and +48 h after the surgery, both in the fasting state and after stimulation with a liquid bolus. The data were recorded
using the Microdigitrapper device and analyzed using the spectral analysis and Fourier transformation. Results: The finding
characteristic in the early postoperative period was a decrease in frequency of both spontaneous and stimulated gastric contractions
(bradygastria) at +5 h after the intervention, that was followed by rapid return to baseline activity. In patients after LNGB,
the normalization of motility was seen within 24 h, and in patients after LC within 48 h after the intervention. Tachygastria
was not found in any patient who did not have complications, but on the contrary it was found in both patients with significant
dyspepsia after LC. Conclusions: In the early postoperative period after LNGB, significant changes in myoelectric gastric
activity were seen and were characterized by transient bradygastria. Comparison with the reference group of patients after
LC shows that the intensity and duration of basal and stimulated bradygastria has a non-specific relationship with the extent
of tissue trauma caused by the intraabdominal surgery. It is not specific for the gastric banding itself. The method of measuring
the basal stimulated EGG potentials can be used in routine surgical practice as an auxiliary method for evaluation of the
functional status of the gastrointestinal tract after intraabdominal surgery. |
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Keywords: | ELECTROGASTROGRAPHY GASTRIC MYOELECTRIC ACTIVITY MORBID OBESITY BARIATRIC SURGERY LAPAROSCOPY GASTRIC BANDING CHOLECYSTECTOMY |
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