High-resolution Impedance Manometry after Sleeve Gastrectomy: Increased Intragastric Pressure and Reflux are Frequent Events

Introduction and Purpose Sleeve gastrectomy (SG) is gaining ground in the field of bariatric surgery. Data are scarce on its impact on esophagogastric physiology. Our aim was to evaluate the impact of SG on esophagogastric motility with high-resolution impedance manometry (HRIM) and to assess the us...

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Bibliographic Details
Published in:Obesity surgery 2016-10, Vol.26 (10), p.2449-2456
Main Authors: Mion, François, Tolone, Salvatore, Garros, Aurélien, Savarino, Edoardo, Pelascini, Elise, Robert, Maud, Poncet, Gilles, Valette, Pierre-Jean, Marjoux, Sophie, Docimo, Ludovico, Roman, Sabine
Format: Article
Language:English
Subjects:
Adult
Electric Impedance
Esophageal Motility Disorders - diagnosis
Esophageal Motility Disorders - etiology
Esophageal Motility Disorders - physiopathology
Esophagus - physiopathology
Female
Gastrectomy - adverse effects
Gastrectomy - methods
Gastric Emptying
Gastroesophageal reflux
Gastroesophageal Reflux - diagnosis
Gastroesophageal Reflux - etiology
Gastrointestinal surgery
Humans
Male
Manometry
Medicine
Medicine & Public Health
Middle Aged
Obesity
Obesity - surgery
Original Contributions
Pressure
Retrospective Studies
Stomach - physiopathology
Surgery
Surgical outcomes
Surgical techniques
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Summary:Introduction and Purpose Sleeve gastrectomy (SG) is gaining ground in the field of bariatric surgery. Data are scarce on its impact on esophagogastric physiology. Our aim was to evaluate the impact of SG on esophagogastric motility with high-resolution impedance manometry (HRIM) and to assess the usefulness of HRIM in patients with upper gastrointestinal (GI) symptoms after SG. Methods A retrospective analysis of 53 cases of HRIM performed after SG was conducted. Upper GI symptoms at the time of HRIM were scored. HRIM was analyzed according to the Chicago classification v3.0. A special attention was devoted to the occurrence of increased intragastric pressure (IIGP) after water swallows and reflux episodes as detected with impedance. A measurement of sleeve volume and diameter was performed with CT scan in a subgroup of patients. Results IIGP occurred very frequently in patients after SG (77 %) and was not associated with any upper GI symptoms, specific esophageal manometric profile, or impedance reflux. Impedance reflux episodes were also frequently observed after SG (52 %): they were significantly associated with gastroesophageal reflux (GER) symptoms and ineffective esophageal motility. The sleeve volume and diameters were also significantly smaller in patients with impedance reflux episodes ( p  
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-016-2127-y