Background: Despite the positive effect of sleeve gastrectomy regarding weight loss and improvement in obesity co-morbidities, there are concerns about its effect on esophageal motility especially the effect on lower esophageal sphincter function and the development of de novo GERD or worsening the existing GERD after this bariatric operation.
Aim of the study is to compare preoperative with postoperative oesophageal manometric studies in patients undergoing sleeve gastrectomy and study the consequences as well as the preoperative oesophageal motility disorders that might affect the outcome of sleeve gastrectomy in morbidly obese patients.
Methodology: This is a prospective study for patients with morbid obesity treated by LSG from March 2017 to March 2018 in the Department of General Surgery Faculty of Medicine, Benha University Hospital.
Results: As regard symptomatic assessment, five (25%) patients had preoperative heartburn and regurgitation. Two (10%) patients developed de novo heartburn and regurgitation postoperatively. As regard esophagogastroduodenoscopy and focusing on esophagus, four (20%) patients had reflux esophagitis before LSG. Two (10%) patients developed de novo reflux esophagitis six months after LSG. As regard esophageal manometry, LES resting pressure decreased from 15.4 (15.4±7) mmHg to 14.1mmHg (14.1±7). As regard 24 hours pH monitoring, four (20%) patients had abnormal DeMeester score preoperatively, which increased postoperatively to 7 (35%) patients.
Conclusion: Our results demonstrate that LSG affects the antireflux mechanism and increases the postoperative GERD. So, bariatric surgeons should carefully evaluate any potential preoperative GERD-related complaints, and take this into account when choosing the proper bariatric surgical technique.
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