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Impact of Laparoscopic Sleeve Gastrectomy on Upper Gastrointestinal Symptoms

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Abstract

Background

Altered gastric anatomy following laparoscopic sleeve gastrectomy (LSG) is likely to induce upper gastrointestinal (GI) symptoms. Published studies, however, have focused mainly on gastroesophageal reflux disease (GERD). This study aims to evaluate LSG's impact on the prevalence of upper GI symptoms and to assess the effects of time from surgery, weight loss, and proton pump inhibitor (PPI) therapy.

Methods

The validated Rome III Criteria symptom questionnaire for upper GI symptoms, including quality of life items, has been self-administered to 97 patients who underwent LSG. Symptoms were analyzed either separately or altogether to classify patients in GERD or dyspepsia, subdivided in epigastric pain (EPS) and post-prandial distress (PDS) syndromes.

Results

Before LSG, 52.7 % of the patients were asymptomatic, 27.0 % had GERD, and 8.1 % had dyspepsia (2.7 % EPS, 5.4 % PDS). After a median follow-up of 13 months, 91.9 % of the patients complained of upper GI symptoms, the most prevalent being PDS (59.4 %). GERD prevalence did not differ before and after LSG. The only symptom strongly related to LSG was dysphagia (OR 4.7, 95 % CI 1.3–20.4, p = 0.015), which was present in 19.7 % of the patients and mainly associated with PDS rather than GERD. GI symptoms, however, did not have a great impact on quality of life. Time from surgery, weight loss after surgery, as well as concomitant PPI, did not influence the symptoms.

Conclusions

After a median follow-up of 13 months, PDS-like dyspepsia, rather than GERD, was the main complaint, both poorly responding to PPI therapy. A longer follow-up will be necessary to evaluate their future persistency.

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Conflict of Interest

All authors have no conflict of interest.

Grant information

This study was in part supported by grants of the University of Rome Sapienza (grant numbers B8SE10002290005 and FARI 2010 8112012).

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Specialties, University of Rome “Sapienza”, viale del Policlinico 155, 00161, Rome, Italy

    Marilia Carabotti, Luca Piretta, Enrico Corazziari & Carola Severi

  2. Department of Medical Surgical Sciences and Biotechnology, University of Rome “Sapienza”, Polo Pontino, corso della repubblica 79, 04100, Latina, Italy

    Gianfranco Silecchia & Mario Rizzello

  3. AUSL Viterbo Ospedale Andosilla, via Ferretti 169, 01033, Civita Castellana, VT, Italy

    Francesco Greco

  4. Department of Experimental Medicine, University of Rome “Sapienza”, viale del Policlinico 155, 00161, Rome, Italy

    Frida Leonetti

  5. Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza”, Polo Pontino, via F. Faggiana 34, 04100, Latina, Italy

    Marco Rengo

  6. Department of Public Health and Infectious Diseases, University of Rome “Sapienza”, Piazzale Aldo Moro 5, 00185, Rome, Italy

    John Osborn

Authors
  1. Marilia Carabotti
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  2. Gianfranco Silecchia
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  3. Francesco Greco
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  4. Frida Leonetti
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  5. Luca Piretta
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  6. Marco Rengo
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  7. Mario Rizzello
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  8. John Osborn
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  9. Enrico Corazziari
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  10. Carola Severi
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Corresponding author

Correspondence to Carola Severi.

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Carabotti, M., Silecchia, G., Greco, F. et al. Impact of Laparoscopic Sleeve Gastrectomy on Upper Gastrointestinal Symptoms. OBES SURG 23, 1551–1557 (2013). https://doi.org/10.1007/s11695-013-0973-4

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  • DOI: https://doi.org/10.1007/s11695-013-0973-4

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