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The Protective Effect of Transit Bipartition and Its Modification Against Sleeve Gastrectomy-Related Esophagitis in a Rodent Model

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Abstract

Background

The protective effect of transit bipartition against esophagitis has not yet been proven. Thus, we investigate and compare the bariatric outcomes and esophagus’ histological changes of sleeve gastrectomy (SG), SG with transit bipartition (SG-TB), and the proximal SG-TB (SG-PTB) in a rodent model.

Methods

This study included 45 diabetic Sprague–Dawley rats assigned to one of the four groups, SG-PTB (n = 15), SG-TB (n = 12), SG (n = 10), and SHAM (n = 8). Eight surviving rats from each group were included for further investigation. Histological analysis of the gastroesophageal junction was performed. Body weight, food intake, glucose control, and hormonal changes (glucagon-like peptide-1 and insulin) were assessed before and after surgery in all groups.

Results

Preoperatively, no significant differences were observed in food intake, body weight, and fasting blood glucose levels among the groups. Postoperatively, the SG-PTB and SG-TB groups showed significantly superior glucose control compared to the SG group following the gavage of glucose (p < 0.05). Postoperatively, the SG-PTB and SG-TB groups had higher postoperative GLP-1 levels than postoperative SG and SHAM groups. More severe esophageal hyperpapillomatosis (EHP) of the esophageal section was observed in the SG group. The mucosal height of the SG group was significantly higher than that of the SG-PTB, SG-TB, and SHAM groups (p < 0.05).

Conclusion

The transit bipartition procedure may protect the distal esophagus from histological changes associated with esophagitis. Clinical studies are needed to confirm the anti-reflux effects of transit bipartition.

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Funding

This study was supported by the Science and Technology Program Project of Xuzhou (KC19157).

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Author notes

  1. Meng Wang and Jason Widjaja contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, 221002, People’s Republic of China

    Meng Wang, Jason Widjaja, Ponnie Robertlee Dolo, Libin Yao, Jian Hong & Xiaocheng Zhu

Authors
  1. Meng Wang
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  2. Jason Widjaja
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  3. Ponnie Robertlee Dolo
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  4. Libin Yao
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  5. Jian Hong
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  6. Xiaocheng Zhu
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Corresponding author

Correspondence to Xiaocheng Zhu.

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Statement of Animal Right

All applicable institutional and national guidelines of the People’s Republic of China for the care and use of animals were followed.

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The authors declare no competing interests.

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Key Points

• A more severe esophageal hyperpapillomatosis (EHP) of the esophageal section was observed in the sleeve gastrectomy (SG) group, but not in the sleeve gastrectomy with transit bipartition (SG-TB) and sleeve gastrectomy with proximal transit bipartition (SG-PTB).

• Compared to SG, SG-TB may protect the distal esophagus from the histological changes associated with esophagitis.

• There is no significant difference esophageal hyperpapillomatosis (EHP) of the esophageal section between the SG-TB and SG-PTB models.

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Wang, M., Widjaja, J., Dolo, P.R. et al. The Protective Effect of Transit Bipartition and Its Modification Against Sleeve Gastrectomy-Related Esophagitis in a Rodent Model. OBES SURG 32, 1149–1156 (2022). https://doi.org/10.1007/s11695-022-05907-2

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  • DOI: https://doi.org/10.1007/s11695-022-05907-2

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