Esophageal motility after laparoscopic sleeve gastrectomy

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Surgical Endoscopy

Background:

• Laparoscopic sleeve gastrectomy (LSG) impacts upper gastrointestinal motility, but data on esophageal function remain controversial.
• Evaluating changes in esophageal motility post-LSG is crucial for understanding patient outcomes.

Purpose of the Study:

• To assess esophageal motility before and after laparoscopic sleeve gastrectomy (LSG).
• To correlate changes in esophageal function with reflux symptoms like heartburn and regurgitation.

Main Methods:

• Prospective evaluation of morbidly obese patients undergoing LSG.
• Preoperative and postoperative reflux symptom assessment and esophageal manometry.
• Analysis of changes in lower esophageal sphincter (LES) pressure, length, and esophageal body peristalsis.

Main Results:

• LSG led to decreased LES length and pressure, with a trend towards reduced resting and residual pressures.
• Esophageal body peristalsis amplitude pressure decreased, particularly at the upper LES border, but normalized postoperatively.
• While heartburn improved in some, regurgitation worsened in others, correlating with reduced LES length.

Conclusions:

• LSG alters LES dimensions and pressure, potentially impacting esophageal peristalsis.
• Despite LES changes, esophageal body peristalsis normalizes, and heartburn may not be exacerbated by LSG.
• Increased regurgitation post-LSG may be linked to shortened LES length, especially in specific patient groups.