INTRODUCTION: the relationship between laparoscopic vertical gastrectomy (LVG) and gastroesophageal reflux (GER) is still controversial. Therefore, its study is of great interest in order to obtain definitive conclusions. The goal of the study was to establish whether LVG modifies pH-metric GER in obese patients and to analyze the associated factors. PATIENTS AND METHODS: the first 26 patients who underwent LVG in our institution were enrolled in the study. A barium swallow, 24-hour ambulatory pH-metry and four-channel intraluminal esophageal manometry (IEM) were all performed before and one year after surgery. RESULTS: among the pH-metric data, there was a significant increase in the DeMeester index after the procedure (p = 0.028), while other parameters remained unchanged. Furthermore, 50% of patients with preoperative pH-metric GER had normal values at one year after surgery. IEM showed a decrease in lower esophageal sphincter (LES) pressure and in the mean wave amplitude at the distal third of the esophagus (p = 0.007 and p = 0.025, respectively). The rate of newly-developed hiatal hernias in the radiographic study was 36.4%. CONCLUSION: LVG mildly increases GER, which is likely related to the development of hiatal hernias and a decrease in LES pressure and esophageal sweep. However, LVG should not be contraindicated for patients with preoperative pH-metric GER, as this may clear after the procedure.
INTRODUCTION: the relationship between laparoscopic vertical gastrectomy (LVG) and gastroesophageal reflux (GER) is still controversial. Therefore, its study is of great interest in order to obtain definitive conclusions. The goal of the study was to establish whether LVG modifies pH-metric GER in obesepatients and to analyze the associated factors. PATIENTS AND METHODS: the first 26 patients who underwent LVG in our institution were enrolled in the study. A barium swallow, 24-hour ambulatory pH-metry and four-channel intraluminal esophageal manometry (IEM) were all performed before and one year after surgery. RESULTS: among the pH-metric data, there was a significant increase in the DeMeester index after the procedure (p = 0.028), while other parameters remained unchanged. Furthermore, 50% of patients with preoperative pH-metric GER had normal values at one year after surgery. IEM showed a decrease in lower esophageal sphincter (LES) pressure and in the mean wave amplitude at the distal third of the esophagus (p = 0.007 and p = 0.025, respectively). The rate of newly-developed hiatal hernias in the radiographic study was 36.4%. CONCLUSION: LVG mildly increases GER, which is likely related to the development of hiatal hernias and a decrease in LES pressure and esophageal sweep. However, LVG should not be contraindicated for patients with preoperative pH-metric GER, as this may clear after the procedure.
Authors: David Ruiz de Angulo; Andrés Balaguer Román; Vicente Munitiz Ruiz; Pedro José Gil Vázquez; Guadalupe Ruiz Merino; M Ángeles Ortiz Escandell; Luisa F Martínez de Haro; Pascual Parrilla Paricio Journal: Cir Esp (Engl Ed) Date: 2020-08-15
Authors: David Ruiz de Angulo; Andrés Balaguer Román; Vicente Munitiz Ruiz; Pedro José Gil Vázquez; Guadalupe Ruiz Merino; M Ángeles Ortiz Escandell; Luisa F Martínez de Haro; Pascual Parrilla Paricio Journal: Cir Esp Date: 2020-08-15 Impact factor: 1.653
Authors: David Ruiz de Angulo; Andrés Balaguer Román; Vicente Munitiz Ruiz; Pedro José Gil Vázquez; Guadalupe Ruiz Merino; M Ángeles Ortiz Escandell; Luisa F Martínez de Haro; Pascual Parrilla Paricio Journal: Cir Esp (Engl Ed) Date: 2021-05-12