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Obesity Surgery
Published in: Obesity Surgery 10/2016

01-10-2016 | Original Contributions

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

Authors: François Mion, Salvatore Tolone, Aurélien Garros, Edoardo Savarino, Elise Pelascini, Maud Robert, Gilles Poncet, Pierre-Jean Valette, Sophie Marjoux, Ludovico Docimo, Sabine Roman

Published in: Obesity Surgery | Issue 10/2016

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Abstract

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 < 0.01).

Conclusion

SG significantly modified esophagogastric motility. IIGP is frequent, not correlated to symptoms, and should be regarded as a HRIM marker of SG. Impedance reflux episodes were also frequent, associated with GER symptoms and esophageal dysmotility. HRIM may thus have a clinical impact on the management of patients with upper GI symptoms after SG.
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Metadata
Title
High-resolution Impedance Manometry after Sleeve Gastrectomy: Increased Intragastric Pressure and Reflux are Frequent Events
Authors
François Mion
Salvatore Tolone
Aurélien Garros
Edoardo Savarino
Elise Pelascini
Maud Robert
Gilles Poncet
Pierre-Jean Valette
Sophie Marjoux
Ludovico Docimo
Sabine Roman
Publication date
01-10-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2127-y

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