Does laparoscopic sleeve gastrectomy have any influence on gastroesophageal reflux disease? Preliminary results

Abstract

Our preliminary data showed that after LSG LESP significantly decreased, and the DeMeester score significantly increased. Although LSG results appear appealing in terms of weight loss, patients should be warned that they might need proton pump inhibitors after the operation. Surgeons should probably lower their threshold for indicating RYGB in patients with known preoperative GERD.

Gastroesophageal Reflux Disease and Sleeve Gastrectomy

“…On the contrary patients without reflux present a LESP of 18.3±4.2 mmHg (range 12.2 to 18.3) [28]. Gorodner [29] recently published that LESP is significantly decreased after LSG, while DeMeester score significantly increased.…”

The Effect of Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair on Gastroesophageal Reflux Disease in the Morbidly Obese

“…In a recent metaanalysis by Karmali et al, a review of 15 studies found that 4 studies reported increased incidence of GERD after sleeve gastrectomy while 7 studies reported a reduced GERD prevalence after sleeve gastrectomy [8]. Similarly, manometric testing of the lower esophageal sphincter before and after LSG has yielded conflicting results [9][10][11][12].…”

Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis

“…29 in total acid exposure of 193% and 102% respectively. 29,32 Furthermore, an increase in the DeMeester score of 125% was found, together with 36% of the patients demonstrating "denovo" pathologic 24-hr pH-results at 12 months follow-up. 32 Rebecchi et al included 28 patients with pre-operative pathologic esophageal acid exposure and 37 patients with normal pHresults.…”

“…29,32 Furthermore, an increase in the DeMeester score of 125% was found, together with 36% of the patients demonstrating "denovo" pathologic 24-hr pH-results at 12 months follow-up. 32 Rebecchi et al included 28 patients with pre-operative pathologic esophageal acid exposure and 37 patients with normal pHresults. 54 Within the pathologic group and the normal group, a postoperative decrease in total esophageal acid exposure of 58.8% and an increase of 9.4% respectively were found.…”

“…Seven studies reporting the incidence of new-onset GERD symptoms using (standardized) questionnaires could be pooled. 28,29,32,33,38,43,54 The pooled incidence of new-onset GERD symptoms for these patients was 20%. There was a strong suggestion of heterogeneity among these studies (I 2 =68 %)( Figure 3).…”