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Abstract

Introduction: Sleeve gastrectomy is a commonly performed metabolic and bariatric procedure associated with exacerbating or precipitating gastro-oesophageal reflux disease (GORD). It is a common belief that the apparent shape and dimensions of the stomach seen on postoperative gastrografin swallow may be predictive of GORD.

Methods: All procedures were performed by a single surgeon within a single center who routinely conducted early postoperative gastrografin swallow. One independent assessor evaluated the apparent shape and dimensions of the gastric sleeve. Another assessor used a questionnaire to assess clinical reflux and quality of eating. Together, this data was systemically analyzed to determine whether the gastric sleeve’s apparent shape could predict GORD.

Results: Routine post-operative gastrografin swallow of 50 patients did not predict GORD at an average of 28 months from surgery. Post-operative reflux is weakly correlated preoperative anti-reflux medication use (r=0.34, p=0.02) and preoperative regurgitation (r=0.32, p=0.03).

Conclusion: The apparent shape of the sleeve pictured on early routine post-gastrografin swallow post-surgery was not a predictor of reflux in this group of patients with at least 18 months of follow up.

Keywords: Sleeve gastrectomy; large fundus; reflux; Postoperative swallow