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Effects of omega-loop bypass on esophagogastric junction function.
Surg Obes Relat Dis 2016; 12(1):62-9SO

Abstract

BACKGROUND

At present, no objective data are available on the effect of omega-loop gastric bypass (OGB) on gastroesophageal junction and reflux.

OBJECTIVES

To evaluate the possible effects of OGB on esophageal motor function and a possible increase in gastroesophageal reflux.

SETTING

University Hospital, Italy; Public Hospital, Italy.

METHODS

Patients underwent clinical assessment for reflux symptoms, and endoscopy plus high-resolution impedance manometry (HRiM) and 24-hour pH-impedance monitoring (MII-pH) before and 1 year after OGB. A group of obese patients who underwent sleeve gastrectomy (SG) were included as the control population.

RESULTS

Fifteen OGB patients were included in the study. After surgery, none of the patients reported de novo heartburn or regurgitation. At endoscopic follow-up 1 year after surgery, esophagitis was absent in all patients and no biliary gastritis or presence of bile was recorded. Manometric features and patterns did not vary significantly after surgery, whereas intragastric pressures (IGP) and gastroesophageal pressure gradient (GEPG) statistically diminished (from a median of 15 to 9.5, P<.01, and from 10.3 to 6.4, P<.01, respectively) after OGB. In contrast, SG induced a significant elevation in both parameters (from a median of 14.8 to 18.8, P<.01, and from 10.1 to 13.1, P<.01, respectively). A dramatic decrease in the number of reflux events (from a median of 41 to 7; P<.01) was observed after OGB, whereas in patients who underwent SG a significant increase in esophageal acid exposure and number of reflux episodes (from a median of 33 to 53; P<.01) was noted.

CONCLUSIONS

In contrast to SG, OGB did not compromise the gastroesophageal junction function and did not increase gastroesophageal reflux, which was explained by the lack of increased IGP and in GEPG as assessed by HRiM.

Authors+Show Affiliations

Division of General and Bariatric Surgery, Department of Surgery, Second University of Naples, Naples, Italy. Electronic address: salvatore.tolone@unina2.it.General and Bariatric Surgery Unit, Camilliani Hospital, Casoria, Italy.Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.General and Bariatric Surgery Unit, Camilliani Hospital, Casoria, Italy.General and Bariatric Surgery Unit, Camilliani Hospital, Casoria, Italy.Division of General and Bariatric Surgery, Department of Surgery, Second University of Naples, Naples, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25979206

Citation

Tolone, Salvatore, et al. "Effects of Omega-loop Bypass On Esophagogastric Junction Function." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 12, no. 1, 2016, pp. 62-9.
Tolone S, Cristiano S, Savarino E, et al. Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis. 2016;12(1):62-9.
Tolone, S., Cristiano, S., Savarino, E., Lucido, F. S., Fico, D. I., & Docimo, L. (2016). Effects of omega-loop bypass on esophagogastric junction function. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 12(1), pp. 62-9. doi:10.1016/j.soard.2015.03.011.
Tolone S, et al. Effects of Omega-loop Bypass On Esophagogastric Junction Function. Surg Obes Relat Dis. 2016;12(1):62-9. PubMed PMID: 25979206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of omega-loop bypass on esophagogastric junction function. AU - Tolone,Salvatore, AU - Cristiano,Stefano, AU - Savarino,Edoardo, AU - Lucido,Francesco Saverio, AU - Fico,Domenico Ivan, AU - Docimo,Ludovico, Y1 - 2015/03/27/ PY - 2015/01/27/received PY - 2015/03/05/revised PY - 2015/03/22/accepted PY - 2015/5/17/entrez PY - 2015/5/17/pubmed PY - 2016/12/15/medline KW - Bariatric surgery KW - GERD KW - High-resolution manometry KW - Impedance KW - MII-pH KW - Obesity KW - Omega-loop gastric bypass KW - One-anastomosis gastric bypass KW - Reflux SP - 62 EP - 9 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 12 IS - 1 N2 - BACKGROUND: At present, no objective data are available on the effect of omega-loop gastric bypass (OGB) on gastroesophageal junction and reflux. OBJECTIVES: To evaluate the possible effects of OGB on esophageal motor function and a possible increase in gastroesophageal reflux. SETTING: University Hospital, Italy; Public Hospital, Italy. METHODS: Patients underwent clinical assessment for reflux symptoms, and endoscopy plus high-resolution impedance manometry (HRiM) and 24-hour pH-impedance monitoring (MII-pH) before and 1 year after OGB. A group of obese patients who underwent sleeve gastrectomy (SG) were included as the control population. RESULTS: Fifteen OGB patients were included in the study. After surgery, none of the patients reported de novo heartburn or regurgitation. At endoscopic follow-up 1 year after surgery, esophagitis was absent in all patients and no biliary gastritis or presence of bile was recorded. Manometric features and patterns did not vary significantly after surgery, whereas intragastric pressures (IGP) and gastroesophageal pressure gradient (GEPG) statistically diminished (from a median of 15 to 9.5, P<.01, and from 10.3 to 6.4, P<.01, respectively) after OGB. In contrast, SG induced a significant elevation in both parameters (from a median of 14.8 to 18.8, P<.01, and from 10.1 to 13.1, P<.01, respectively). A dramatic decrease in the number of reflux events (from a median of 41 to 7; P<.01) was observed after OGB, whereas in patients who underwent SG a significant increase in esophageal acid exposure and number of reflux episodes (from a median of 33 to 53; P<.01) was noted. CONCLUSIONS: In contrast to SG, OGB did not compromise the gastroesophageal junction function and did not increase gastroesophageal reflux, which was explained by the lack of increased IGP and in GEPG as assessed by HRiM. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/25979206/Effects_of_omega_loop_bypass_on_esophagogastric_junction_function_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(15)00081-7 DB - PRIME DP - Unbound Medicine ER -