Dilated Upper Sleeve Can be Associated with Severe Postoperative Gastroesophageal Dysmotility and Reflux

Keidar, Andrei; Appelbaum, Liat; Schweiger, Chaya; Elazary, Ram; Baltasar, Aniceto

doi:10.1007/s11695-009-0032-3

Cited by 114 publications

(56 citation statements)

References 14 publications

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“…This in combination with a hypotensive lower esophageal sphincter either preexisting or as a result of LSG could have led to onset of new GERD symptoms [31]. Another proposed mechanism is a relative dilation of the fundal portion of the sleeve with a narrowed distal portion which could lead to stasis and resultant increased acid production [32]. This could happen when excess fundus (a more distensible part of the stomach) is left while fashioning the upper part of the sleeve resection.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic sleeve gastrectomy for obesity: can it be considered a definitive procedure?

et al. 2011

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Section: Resultsmentioning

confidence: 99%

Laparoscopic sleeve gastrectomy for obesity: can it be considered a definitive procedure?

et al. 2011

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“…According to literature there is a consensus that gastric bypass represents an anti-reflux procedure, whereas data concerning GERD after LSG are controversial [35][36][37][38][39][40][41]. Yet it is unclear whether LSG reduces or induces symptoms of GERD.…”

Section: Discussionmentioning

confidence: 99%

Technique and results of single-step laparoscopic sleeve resection*

et al. 2012

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Background: The epidemic of obesity assumes vast proportions with approximately estimated 2.3 billion overweight adults and more than 700 millions defined as obese according to the World Health Organization in 2015. The close relation between obesity and its co-morbidities such as hypertension, insulin resistance and diabetes mellitus type 2 are well documented. Laparoscopic sleeve gastrectomy (LSG) was initially described as a first-step procedure followed by either biliopancreatic diversion with duodenal switch (BPD-DS) or Roux-en-Y gastric bypass (RYGBP) in super-super obese patients (i.e. BMI>60 kg/m 2 ) or in high-risk patients. On the other hand the role of LSG as a single procedure is yet unclear and controversial.Methods: We report about 83 patients enrolled for LSG as single bariatric procedure and a follow-up period of 12 months or more. Follow-up was performed continuously every 3 months and data regarding weight loss, GERD and subjective well-being as well as blood samples were collected. Mean preoperative BMI was 49 kg/m 2 (range 38-74).Results: Within 12 months patients reached a mean EWL of 63% (31-90%). 22 patients, who suffered preoperatively from diabetes mellitus type 2 showed amelioriation of the disease. Hba1c levels dropped from 6.2% to 5.3%. In 2 (2.4%) cases patients had to be reoperated because of bleeding. 1 (1.2%) patient underwent reoperation because of leakage of the staple line. 13 (15.7%) patients complained about GERD symptoms. Some patients showed occasional symptoms, others could be treated conservatively.Conclusions: Single-step LSG is very well accepted by patients and seems to be efficient regarding weight loss, although large studies concerning long-term results are still rare. In our patients there are some cases of GERD, which seem to ameliorate in the course of time, but objective data are still lacking and further evaluation is necessary.

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“…Therefore, the true incidence of this complication after sleeve gastrectomy is unknown. The works that do report the incidence cite numbers from as low as 0.1 % for prolonged vomiting and 0.2 % for delayed gastric emptying [ 36 ] to as high as 13-30 % [ 37 ]. Symptomatic GERD has been reported to occur in 7.8-20 % of patients at 12-24 months after LSG in a selected series of more than 100 patients.…”

Section: Post-lsg Gerdmentioning

confidence: 99%