Evaluation of gastroesophageal reflux after laparoscopic cholecystectomy using combined impedance-pH monitoring.
OBJECTIVE
Postoperative gastroesophageal reflux (GER) is one of the causes of post-cholecystectomy syndrome (PCS). Reports studying the effect of cholecystectomy on GER show conflicting results and only a few studies have used the more sensitive technique of combined impedance-pH monitoring. This study aimed to study the effect of laparoscopic cholestectomy on GER (acid/non-acid reflux) using impedance-pH monitoring.


METHODS
Sixty three consecutive patients of symptomatic cholelithiasis were evaluated. All patients underwent esophageal mannometry and 24-hour impedance-pH monitoring pre- and postoperatively. Frequency scale for the symptoms of GERD (FSSG) scoring was also done in each patient pre- and postoperatively.


RESULTS
Out of sixty three patients, four developed symptoms of reflux postoperatively as detected by FSSG scoring. However, no significant changes were observed in lower esophageal sphincter (LES) characteristics, acid and non-acid reflux characteristics, total number of reflux episodes, or in the physical character of the refluxate following laparoscopic cholecystectomy. Significant decrease in the proximal acid reflux episodes was observed.


CONCLUSIONS
The chemical characteristics (acid or non-acid reflux) as well as physical properties (liquid, gas or mixed) of reflux episodes remain unaffected following laparoscopic cholecystectomy. Cholecystectomy itself doesn't increases GER.
Rigved
R
Gupta
Gaurav
G
Kochhar
Ashok
A
Kumar
Sudipta
S
Saha
Manoj
M
Andley
Rahul
R
Pusuluri
Gyan
G
Saurabh
Ajay
A
Kumar
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007194:India / Q000453:epidemiology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D017562:Postcholecystectomy Syndrome / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult