Dumping Symptoms and Incidence of Hypoglycaemia After Provocation Test at 6 and 12 Months After Laparoscopic Sleeve Gastrectomy

Abstract

A previous study has demonstrated that symptoms suggestive of dumping syndrome appear after a provocation test early after laparoscopic sleeve gastrectomy (LSG) in 45% of patients, and these are mainly related to early dumping. The aim of this study is to evaluate the evolution of dumping symptoms during the first postoperative year. Twenty-five non-diabetic morbidly obese patients (6 male, 19 female) were evaluated with an oral glucose tolerance test (OGTT) preoperatively, at 6weeks and at 6months postoperatively. In addition, 12 of them repeated the OGTT at 12months after LSG. Sigstad score was used to separate dumpers from non-dumpers and Arts' questionnaire to differentiate between early and late dumping. Insulin and glucose levels were also measured. Sigstad score remained significantly elevated at 6 and 12months postoperatively compared to preoperative values. Symptoms suggestive of dumping syndrome were recorded in 40% of patients at 6months and in 33% at 12months postoperatively. Arts' questionnaire demonstrated that early dumping score remained higher compared to baseline at 6 and 12months postoperatively. Late dumping scores increased gradually during the time and that difference was statistically significant at 12months after LSG. Hypoglycaemia occurred at 33% of patients both at 6 and 12months postoperatively. Symptoms suggestive of dumping syndrome after provocation still exist at 6 and 12months in a significant proportion of patients after LSG and include both early and late dumping. These findings are consistent with the high incidence of hypoglycaemia after OGTT at 6 and 12months after LSG.