Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus.

Abstract Background Published data on sleeve gastrectomy (SG) have indicated better remission of type 2 diabetes mellitus (T2DM) and improvement in satiety compared with other restrictive procedures. Mechanisms in addition to rapid, extensive weight loss are responsible for the restoration of the euglycemic state. To prospectively evaluate the role of laparoscopic SG on gastric emptying half-time and small bowel transit time (SBTT) and effect of these on weight loss, satiety, and improvement in T2DM. Methods A total of 67 subjects were studied. Of these 67 subjects, 24 were lean controls (body mass index 22.2 ± 2.84 kg/m 2 ), 20 were severely and morbidly obese patients with T2DM who had not undergone SG (body mass index 37.73 ± 5.35 kg/m 2 ), and 23 were severely and morbidly obese patients with T2DM after SG (body mass index 40.71 ± 6.59 kg/m 2 ). All 67 patients were evaluated for gastric emptying half-time and SBTT using scintigraphic imaging. Imaging was performed every 15 minutes up to the ileocecal region. The Three-Factor Eating Questionnaire was administered simultaneously. Fasting blood sugar, postprandial blood sugar, and glycated hemoglobin were assessed. Nonparametric analysis of variance and the Mann-Whitney U test were applied. Results The mean SBTT was significantly lower ( P P P Conclusion A decreased gastric emptying half-time and SBTT after SG can possibly contribute to better glucose homeostasis in patients with T2DM.