Can morbidly obese patients with reflux be offered laparoscopic sleeve gastrectomy? A case report of 40 patients

American Journal of Surgery
Abdelkader HawasliSusanna Szpunar

Abstract

The incidence of reflux in obesity can reach greater than 35%. Most surgeons recommend Roux-en-y gastric bypass to patients with pre-existing reflux. One alternative to Roux-en-y gastric bypass is the addition of anterior fundoplication (AF) with posterior crural approximation (pCA) to laparoscopic sleeve gastrectomy (LSG) in patients with documented reflux. Between February 2011 and April 2013 we reviewed data from the bariatric registry on weight loss, resolution of symptoms, and quality of life presurgery and postsurgery for all patients who consented to participate in the registry and underwent LSG with AF/pCA. Forty patients met inclusion criteria; 78% (31) were female. The mean initial weight was 298 ± 64 lbs. with mean BMI of 49 ± 8 kg/m(2). The mean DeMeester score was 36 ± 27 (normal <14.7). Nine (22.5%) patients had esophagitis. Thirty-six (90%) patients had hiatal hernia. There were no intraoperative complications. The mean operative time was 84 ± 20 minutes and the mean hospital stay was 1.6 ± .9 days. Postoperative complications included 1 fluid collection, 1 narrowing, 4 admissions for nausea and dehydration, 1 for pancreatitis, and 1 for deep vein thrombosis . Thirty-eight (95%) patients had immediate resolution ...Continue Reading

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Citations

Jul 28, 2016·Obesity Surgery·Antonio IannelliLuigi Angrisani
Dec 19, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Brad SnyderConniw Klein
Apr 30, 2019·Journal of Minimal Access Surgery·Palanivelu Praveen RajC Palanivelu
Nov 14, 2019·Surgical Endoscopy·P NauUNKNOWN SAGES Foregut Task Force White Paper
Sep 22, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·David NoccaAlmino Ramos
Oct 12, 2017·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Juan Pablo LasnibatFelipe Sanchez

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