CHOLECYSTECTOMY-INDUCED GASTROESOPHAGEAL REFLUX - IS IT REDUCED BY THE LAPAROSCOPIC APPROACH

Objective: The incidence of gastroesophageal reflux and esophagitis in creases significantly following cholecystectomy, Laparoscopic techniqu e minimizes the metabolic and mechanical disturbances of cholecystecto my, but there has been no study of its effects on gastroesophageal ref lux. The aim of this study,vas to examine the effect of laparoscopic c holecystectomy on the indices of gastroesophageal reflux. Methods: A p rospective study was carried out on patients scheduled for cholecystec tomy, Informed consent was obtained, Preoperative 24-h pH studies and manometry were performed, Studies were repeated 3 months after surgery , Pathological acid reflux was defined in terms of the DeMeester acid score, Results: Pre- and postoperative studies were carried out on 28 patients who had open cholecystectomy and on 22 patients who had lapar oscopic cholecystectomy. The mean (SEM) DeMeester acid score increased from 14.8 (2.4) to 34.0 (6.7) following open cholecystectomy (p = 0.0 06) and from 13.9 (2.5) to 28.9 (4.3) following laparoscopic cholecyst ectomy (p = 0.002), Decrease in mean lower esophageal sphincter pressu re in both groups was not significant, Conclusions: A significant incr ease in the incidence of gastroesophageal reflux occurred within 3 mon ths after surgery in both study groups, Despite the less invasive natu re of laparoscopic cholecystectomy, the type of surgery did not influe nce the degree of esophageal dysfunction.