Influence of Sleeve Gastrectomy on Gastro-Esophageal Reflux Disease

Abstract

Background: bariatric operations can induce reflux by affecting organs motor functions depending on the type of procedure performed. Laparoscopic sleeve gastrectomy (LSG) relatively new option of morbid obesity treatment, simpler to perform, short learning curve, and shorter duration (procedure time and hospital stay). Objectives: The aim of this work was to evaluate upper gastrointestinal symptoms before and after sleeve gastrectomy on short term follow up period of 6 months post-operatively and to assess the relation between Gastro-Esophageal Reflux Disease and sleeve gastrectomy. Patients and Methods: This follow up study included 50 morbidly obese patients treated with laparoscopic sleeve gastrectomy during the period from May 2018 to October 2018. Rome III Criteria and upper GI Endoscopy evaluation was done preoperatively then 6 months postoperatively concerning upper GI symptoms. Results: Before LSG 60% asymptomatic, 40 % GERD, 6.7 % dyspepsia (PDS predominance). UGI endoscopy showed 40% no significant findings, 60% gastritis, 20% esophagitis, 13.3% duodenitis, DU 6.7%. 40% H-pylori positive and 60% negative. After 6 months follow-up, 93.3% complained of upper GI symptoms, 66.7 % prevalence of dyspepsia (p<0.001). GERD symptoms disappear in 83.3%. 20% increased Vomiting of all patients associated with GERD (p =0.030). 13.3% increased Dysphagia (p =0.125) associated with dyspepsia. 100% correlation between GERD and hiatus hernia (p<0.001) and 66.7% between vomiting and incompetent cardia (p=0.029). Conclusion: Improvement of Gastro-Esophageal Reflux Disease after Sleeve Gastrectomy in patients complaining of GERD pre-operatively, although there is incidence of post-operative hiatus hernia and develop of gastrointestinal symptoms . Recommendation: further studies have to be applied.