Effect of laparoscopic sleeve gastrectomy on pre-existing and post-operative newly developed upper gastrointestinal symptoms / George Atef Yacoub Bisheet ; Supervised Mohamed Sherif Hathout , Sherif Mohamed Mokhtar , Mohamed Ali Ahmed Elnady

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Obesity is a major public health concern that has many complications and associated with many life threatening comorbidities. LSG is one of the most famous, safe and effective bariatric procedures worldwide with lowest incidence of complications and satisfactory results. Altered gastric anatomy following laparoscopic sleeve gastrectomy (LSG) such as lower esophageal sphincter pressure reduction, lack of gastric compliance, blunting of the angle of His and destruction of the phreno-esophageal ligament is likely to induce UGI symptoms. This study aims to evaluate LSG's impact on the prevalence of upper GI symptoms on short term follow up period of 6 months post-operative. The validated rome III Criteria symptom questionnaire for upper GI symptoms has been conducted to 30 patients who underwent LSG. Before surgery patients were tested for H-pylori in stool, eradicated and undergone UGI endoscopy for identification of any pathological finding. Symptoms were analysed separately and UGI endoscopy was done post-operatively to classify the findings and correlate with UGI symptoms. Before LSG, 60% of the patients were asymptomatic, 40 % had GERD, and 6.7 % had dyspepsia (PDS was predominant). All were subjected to UGI endoscopy and showed no significant finding in 40%, gastritis in 60%, esophagitis in 20%, duodenitis in 13.3% and DU in 6.7%. 40% were H-pylori positive and 60% were H-pylori negative. After a median follow-up of 6 months, 93.3%of the patients complained of upper GI symptoms, the most prevalent being dyspepsia (66.7 %) (p<0.001). GERD prevalence did not differ before and after LSG but GERD symptoms disappear in 83.3%

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