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. 2021 Dec;406(8):2591-2609.
doi: 10.1007/s00423-021-02171-3. Epub 2021 Apr 14.

Manometric and pH-monitoring changes after laparoscopic sleeve gastrectomy: a systematic review

Andrea Balla  1 , Francesca Meoli  2 , Livia Palmieri  2 , Diletta Corallino  2 , Maria Carlotta Sacchi  3 , Emanuela Ribichini  3 , Diego Coletta  4 , Annamaria Pronio  5 , Danilo Badiali  3 , Alessandro M Paganini  2
Affiliations

Manometric and pH-monitoring changes after laparoscopic sleeve gastrectomy: a systematic review

Andrea Balla et al. Langenbecks Arch Surg. 2021 Dec.

Abstract

Purpose: Aim of this systematic review is to assess the changes in esophageal motility and acid exposure of the esophagus through esophageal manometry and 24-hours pH-monitoring before and after laparoscopic sleeve gastrectomy (LSG).

Methods: Articles in which all patients included underwent manometry and/or 24-hours pH-metry or both, before and after LSG, were included. The search was carried out in the PubMed, Embase, Cochrane, and Web of Science databases, revealing overall 13,769 articles. Of these, 9702 were eliminated because they have been found more than once between the searches. Of the remaining 4067 articles, further 4030 were excluded after screening the title and abstract because they did not meet the inclusion criteria. Thirty-seven articles were fully analyzed, and of these, 21 further articles were excluded, finally including 16 articles.

Results: Fourteen and twelve studies reported manometric and pH-metric data from 402 and 547 patients, respectively. At manometry, a decrease of the lower esophageal sphincter resting pressure after surgery was observed in six articles. At 24-hours pH-metry, a worsening of the DeMeester score and/or of the acid exposure time was observed in nine articles and the de novo gastroesophageal reflux disease (GERD) rate that ranged between 17.8 and 69%. A meta-analysis was not performed due to the heterogeneity of data.

Conclusions: After LSG a worsening of GERD evaluated by instrumental exams was observed such as high prevalence of de novo GERD. However, to understand the clinical impact of LSG and the burden of GERD over time further long-term studies are necessary.

Keywords: 24h-pH-impedance; Gastroesophageal reflux disease (GERD); Manometry; Sleeve gastrectomy; pH-metry.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Preferred reporting items for systematic review and meta-analysis (PRISMA) flow diagram [14]. SG: sleeve gastrectomy
Fig. 2
Fig. 2
Lower esophageal sphincter resting pressure trend
Fig. 3
Fig. 3
DeMeester score trend
See this image and copyright information in PMC

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