Gastro-oesophageal after laparoscopic cholecystectomy: a prospective evaluation

ABSTRACT

The lower oesophageal sphincter [LOS] function was studied in 20 patients with symptomatic gall stone disease before and after laparoscopic cholecystectomy. Nine patients [45%] were still symptomatic 3 - 4 months after surgery. Seven patients [35%] had abnormal pH profile before surgery, increased to fourteen patients [70%] following cholecystectomy [P <0.002]. DeMeester acid reflux score increased from 15.2 to 34.2 post surgery [P<0.001]. The LOS function as assessed by the sphincter function index was significantly reduced in patients with abnormal pH profile [P<0.01]. The mean supine gastric alkaline shift increased from 9.2% to 17.7% [P<0.02]. The incidence of gastritis increased from 4 [20%] to 12 patients [60%]. These data suggest that laparoscopic cholecystectomy results in gastro-oesophageal reflux that appears to be related to compromised lower oesophageal sphincter competence