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. 2023 Sep 4:10:1265293.
doi: 10.3389/fsurg.2023.1265293. eCollection 2023.

Ultrasound assessment of gastric content in patients undergoing laparoscopic cholecystectomy after preoperative oral carbohydrates: a prospective, randomized controlled, double-blind study

Yali Ge #  1 , Dejuan Shen #  2 , Yinyin Ding #  1 , Keting Wu  1 , Yang Zhang  1
Affiliations

Ultrasound assessment of gastric content in patients undergoing laparoscopic cholecystectomy after preoperative oral carbohydrates: a prospective, randomized controlled, double-blind study

Yali Ge et al. Front Surg. .

Abstract

Background: To evaluate the gastric volume and nature after drinking preoperative oral carbohydrates in patients undergoing laparoscopic cholecystectomy via ultrasonography.

Methods: One hundred patients who had been scheduled for elective laparoscopic cholecystectomy were enrolled and randomized into the traditional fasting group (Control group, n = 50) and the carbohydrate group (CHO group, n = 50). Patients in the Control group fasted solids and drink from midnight, the day before surgery. Patients in the CHO group drank 800 ml and 400 ml of oral carbohydrates 11 and 3 h before surgery, respectively. At 2 h after oral carbohydrates (T1), all patients underwent an ultrasound examination of residual gastric contents; if the patients had a full stomach, the assessment was performed again 1 h later (T2). A stomach containing solid contents or >1.5 ml/kg of liquid was considered "full". The primary outcome was full stomach incidences at the above time points. The secondary outcomes included gastric antral CSA in the right lateral decubitus (RLD) and semi-sitting positions, as well as gastric volume (GV), GV per weight (GV/kg), and Perla's grade at T1.

Results: Compared with the Control group, the incidence of entire stomach was significantly high in the CHO group 2 h after oral carbohydrates. At the T1 time point, 6 patients (13.3%) in the Control group and 14 patients (30.4%) in the CHO group presented with a full stomach [95% confidence interval (CI), (0.96-5.41), P = 0.049]. At T2, 3 patients (6.7%) in the Control group and 4 patients (8.7%) in the CHO group had a full stomach, with no marked differences between the two groups [95% CI, (0.31-5.50), P = 0.716]. Compared with the Control group, CSA in the semi-sitting and RLD positions, GV and GV/W were significantly high in the CHO group at T1 (P < 0.05). The median (interquartile range) of the Perlas grade was 1 (0-1) in the Control group and 1(1-1.25) in the CHO group (P = 0.004).

Conclusion: Cholecystectomy patients experience a 2 h delay in gastric emptying after receiving preoperative carbohydrates. In LC patients, the fasting window for oral carbohydrates before surgery should be adequately prolonged.

Clinical trail registration: Chinese Clinical Trail Registry, No: ChiCTR2200055245.

Keywords: carbohydrates; cholecystectomy; gastric emptying; gastroparesis; laparoscopic.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study protocol.
Figure 2
Figure 2
Ultrasound images of the stomach antrum when it was in the right lateral decubitus position. In an empty stomach, the gastric antrum appears flat and folded (A). If fluid content is present, the stomach antrum appears swollen and hypoechoic (B). A = antrum; IVC = inferior vena cava; L = liver; P = pancreas.
See this image and copyright information in PMC

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References

    1. Di Ciaula A, Molina-Molina E, Bonfrate L, Wang DQ, Dumitrascu DL, Portincasa P. Gastrointestinal defects in gallstone and cholecystectomized patients. Eur J Clin Invest. (2019) 49(3):e13066. 10.1111/eci.13066 - DOI - PMC - PubMed
    1. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. (2012) 6(2):172–87. 10.5009/gnl.2012.6.2.172 - DOI - PMC - PubMed
    1. Chang JE, Kim H, Won D, Lee JM, Jung JY, Min SW, et al. Ultrasound assessment of gastric content in fasted patients before elective laparoscopic cholecystectomy: a prospective observational single-cohort study. Can J Anaesth. (2020) 67(7):810–6. 10.1007/s12630-020-01668-7 - DOI - PubMed
    1. Van de Putte P, Vernieuwe L, Jerjir A, Verschueren L, Tacken M, Perlas A. When fasted is not empty: a retrospective cohort study of gastric content in fasted surgical patients. Br J Anaesth. (2017) 118(3):363–71. 10.1093/bja/aew435 - DOI - PubMed
    1. Ohashi Y, Walker JC, Zhang F, Prindiville FE, Hanrahan JP, Mendelson R, et al. Preoperative gastric residual volumes in fasted patients measured by bedside ultrasound: a prospective observational study. Anaesth Intensive Care. (2018) 46(6):608–13. 10.1177/0310057X1804600612 - DOI - PubMed

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