Year 2019 / Volume 111 / Number 9
Original
Evolution of gastroesophageal reflux after laparoscopic vertical gastrectomy. A radiographic, manometric and pH-metric study

662-666

DOI: 10.17235/reed.2019.5972/2018

David Ruiz de Angulo, Pilar Jimeno Griño, María Ángeles Ortiz Escandell, Vicente Munitiz Ruiz, Pedro José Gil Vázquez, Domingo Pérez Flores, Luisa Fernanda Martínez de Haro, Antonio Miguel Hernández, Pascual Parrilla Paricio,

Abstract
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.
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Ruiz de Angulo D, Jimeno Griño P, Ortiz Escandell M, Munitiz Ruiz V, Gil Vázquez P, Pérez Flores D, et all. Evolution of gastroesophageal reflux after laparoscopic vertical gastrectomy. A radiographic, manometric and pH-metric study. 5972/2018


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Publication history

Received: 13/10/2018

Accepted: 17/02/2019

Online First: 01/07/2019

Published: 05/09/2019

Article revision time: 121 days

Article Online First time: 261 days

Article editing time: 327 days


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