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Le Page, Philip A.; Martin, David

Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying

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  • Medientyp: E-Artikel
  • Titel: Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying
  • Beteiligte: Le Page, Philip A.; Martin, David
  • Erschienen: Wiley, 2015
  • Erschienen in: World Journal of Surgery
  • Sprache: Englisch
  • DOI: 10.1007/s00268-015-2981-0
  • ISSN: 0364-2313; 1432-2323
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro‐oesophageal reflux. No universal surgical strategy exists for this problem.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A novel surgical strategy combines partial sleeve gastrectomy (SG) and hiatus hernia (HH) repair with fundoplication. A review of treating four such patients is described with objective outcome data.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, solid gastric emptying improved in all, from median 350 (163–488) min pre‐operatively to 108 (84–135) at 10 months (3–24) post‐operatively, corresponding to 67 % improvement. Primary symptoms resolved in all; however, one patient had recurrent symptoms. GERD‐HRQL also improved in all, from median 23 (3–25) to 4 (0–8) at 21 months (6–30, 83 % improvement). Gas bloat improved in three. All had post‐operative gastroscopies showing intact repair and absent oesophagitis, with no patient requiring post‐operative PPI. Patient weight reduced by median 11 % (7–20) post‐operatively. There was no significant peri‐operative morbidity.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>With careful patient selection and work‐up, SG and HH repair with fundoplication may improve quality of life by coupling adequate reflux control with improved gastric emptying.</jats:p></jats:sec>