The Impact of Pyloric Pouch Size (3 cm and 6 cm) in Sleeve Gastrectomy on Postoperative Reflux and Vomiting
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- Category: Vol. 83, September 2015
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The Impact of Pyloric Pouch Size (3 cm and 6 cm) in Sleeve Gastrectomy on Postoperative Reflux and Vomiting, MOHAMED A. EL-MASRY, MUHAMMAD EL-MARZOUKY and YEHIA FAYEZ
Abstract
Some evidence has shown that sleeve gastrectomy and similar procedures can be complicated by significant post-operative reflux symptoms. With an intact pylorus, severely restricted stomach capacity, and physiologically disrupted motility possibly creating stasis, one would expect that LSG would not be likely to relieve heartburn reflux symptoms, as does LRYGB.
Aim of Work: The aim of this study is to find out the impact of resecting the stomach 3cm from the pylorus versus 6cm regarding vomiting and reflux symptoms by randomly selecting the patients presenting to our department with morbid obesity and BMI >40 in Kasr Al-Ainy between January 2013 and March 2014.
Methods: This was a randomly selected prospective study carried out on morbidly obese patients presented to Kasr El-Aini Teaching Hospital during the period from January 2013 to March 2014, where sixty patients underwent sleeve gas-trectomy. These patients grouped into two groups according to the starting point of resection of the stomach; Group (A) started 3cm from the pylorus towards the gastro-esophageal junction and Group (B) 6cm from the pylorus. The decision to do 3cm resection or 6cm resection randomly selected. These patients followed over a period of 6 months for post-operative nausea; vomiting and reflux symptoms where the assessment of the reflux was based mainly on the symptoms given by the patient.
Results: There was no statistical difference between both groups (6cm and 3cm) regarding post-operative reflux, where most of patients (61.7%) didn’t suffer reflux symptom versus (38.3%) who suffered from reflux where most of them had already pre-operative reflux symptoms. In addition, (43.8%) of patients in 3 cm group suffered from reflux versus (32.1 %) in 6cm group who suffered from reflux taking in consideration that the sample size is sixty patients so higher sample size may confirm this correlation.
Conclusion: The 3cm group (Group A) were >14 times at a higher risk to have minor complications in the form of nausea, vomiting and reflux compared to 6cm group (Group B).