Laparoscopic sleeve gastrectomy is a relatively quick and straightforward procedure that offers high weight loss with few complications. Amongst the bariatric procedures, however, it has been reported that LSG has a higher incidence of gastroesophageal reflux which leads to poorer quality of life and increased risk of gastro-esophageal cancers. The proposed mechanisms behind this are many including modification of the oesophageal sphincter, increased gastric pressure gradients and changes to

more »

... tric anatomy. It appears that sleeve gastrectomies have the effect of modifying the gastric emptying time which is a potential risk factor that could affect the incidence and severity of reflux disease. A faster gastric emptying time would lead to less of a pressure gradient and also less time for gastric contents to reflux. Gastric emptying after a sleeve gastrectomy appears to be faster, and this is because of the way a resection interferes with the regulatory mechanisms behind food. Furthermore, the previously conservative gastrectomies that kept more of the antrum have slower emptying times than more radical antral resections. We have concluded from the literature that more antral resections would lead to faster gastric emptying times and therefore minimize the risk of GORD in these patients. Much of this literature is recent, however, and a more formal systematic review is needed especially with earlier conflicting studies. Further research is also needed to see whether antral resections can help minimize gastric reflux in the long-term as well as maintain weight loss.