{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T10:33:40Z","timestamp":1768559620908,"version":"3.49.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T00:00:00Z","timestamp":1682640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T00:00:00Z","timestamp":1682640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bern"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sleeve gastrectomy (SG) is the most frequently performed bariatric surgical intervention worldwide. Gastroesophageal reflux disease (GERD) is frequently observed after SG and is a relevant clinical problem. This prospective study investigated the gastroesophageal junction (GEJ) and pyloric sphincter by impedance planimetry (EndoFlip<jats:sup>TM<\/jats:sup>) and their association with GERD at a tertiary university hospital center. Between January and December 2018, patients undergoing routine laparoscopic SG had pre-, intra-, and postoperative assessments of the GEJ and pyloric sphincter by EndoFlip<jats:sup>TM<\/jats:sup>. The distensibility index (DI) was measured at different volumes and correlated with GERD (in accordance with the Lyon consensus guidelines). Nine patients were included (median age 48 years, preoperative BMI 45.1 kg\/m<jats:sup>2<\/jats:sup>, 55.6% female). GERD (de novo or stable) was observed in 44.4% of patients one year postoperatively. At a 40-ml filling volume, DI increased significantly pre- vs. post-SG of the GEJ (1.4 mm<jats:sup>2<\/jats:sup>\/mmHg [IQR 1.1\u20132.6] vs. 2.9 mm<jats:sup>2<\/jats:sup>\/mmHg [2.6\u20135.3], <jats:italic>p<\/jats:italic> VALUE=0.046) and of the pylorus (6.0 mm<jats:sup>2<\/jats:sup>\/mmHg [4.1\u201310.7] vs. 13.1 mm<jats:sup>2<\/jats:sup>\/mmHg [7.6\u201319.2], <jats:italic>p<\/jats:italic> VALUE=0.046). Patients with postoperative de novo or stable GERD had a significantly increased preoperative DI at 40 ml of the GEJ (2.6 mm<jats:sup>2<\/jats:sup>\/mmHg [1.9\u20133.5] vs. 0.5 mm<jats:sup>2<\/jats:sup>\/mmHg [0.5\u20131.1], <jats:italic>p<\/jats:italic> VALUE=0.031). There was no significant difference in DI at 40 mL filling in the preoperative pylorus and postoperative GEJ or pylorus. In this prospective study, the DI of the GEJ and the pylorus significantly increased after SG. Postoperative GERD was associated with a significantly higher preoperative DI of the GEJ but not of the pylorus.<\/jats:p>\n                <jats:p><jats:bold>Graphical Abstract<\/jats:bold><\/jats:p>","DOI":"10.1007\/s11695-023-06606-2","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T17:01:51Z","timestamp":1682701311000},"page":"2255-2260","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gastroesophageal Junction and Pylorus Distensibility Before and After Sleeve Gastrectomy\u2014pilot Study with EndoFlipTM"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4570-949X","authenticated-orcid":false,"given":"Christian Tibor Josef","family":"Magyar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1997-0675","authenticated-orcid":false,"given":"Yves","family":"Borb\u00e9ly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reiner","family":"Wiest","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3447-264X","authenticated-orcid":false,"given":"Guido","family":"Stirnimann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9924-1749","authenticated-orcid":false,"given":"Daniel","family":"Candinas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Lenglinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp C.","family":"Nett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8736-6619","authenticated-orcid":false,"given":"Dino","family":"Kr\u00f6ll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"6606_CR1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1001\/JAMASURG.2021.4981","volume":"10","author":"R Howard","year":"2021","unstructured":"Howard R, Chao GF, Yang J, Thumma J, Chhabra K, Arterburn DE, et al. Comparative safety of sleeve gastrectomy and gastric bypass up to 5 years after surgery in patients with severe obesity. JAMA Surg. 2021;10:101. https:\/\/doi.org\/10.1001\/JAMASURG.2021.4981.","journal-title":"JAMA Surg."},{"key":"6606_CR2","doi-asserted-by":"publisher","first-page":"1954","DOI":"10.1007\/S11695-019-03817-4","volume-title":"Obes Surg 2019 296","author":"Y Wang","year":"2019","unstructured":"Wang Y, Song Y, Chen J, Zhao R, Xia L, Cui Y, et al. Roux-en-Y gastric bypass versus sleeve gastrectomy for super super obese and super obese: systematic review and meta-analysis of weight results, comorbidity resolution. In:  Obes Surg 2019 296, vol. 29: Springer; 2019. p. 1954\u201364. https:\/\/doi.org\/10.1007\/S11695-019-03817-4."},{"key":"6606_CR3","doi-asserted-by":"publisher","unstructured":"Winckelmann LA, Gribsholt SB, Madsen LR, Richelsen B, Svensson E, J\u00f8rgensen NB, et al. Roux-en-Y gastric bypass versus sleeve gastrectomy: nationwide data from the Danish quality registry for treatment of severe obesity. Surg Obes Relat Dis. Am Soc Metabolic Bartatric Surg. 2021; https:\/\/doi.org\/10.1016\/j.soard.2021.12.015.","DOI":"10.1016\/j.soard.2021.12.015"},{"key":"6606_CR4","doi-asserted-by":"publisher","first-page":"3391","DOI":"10.1007\/S11695-021-05464-0","volume":"31","author":"T-C Soong","year":"2021","unstructured":"Soong T-C, Lee M-H, Lee W-J, Almalki OM, Chen J-C, Wu C-C, et al. Long-term efficacy of bariatric surgery for the treatment of super-obesity: comparison of SG, RYGB, and OAGB. Obes Surg 2021 318. Springer. 2021;31:3391\u20139. https:\/\/doi.org\/10.1007\/S11695-021-05464-0.","journal-title":"Springer"},{"key":"6606_CR5","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1136\/GUTJNL-2012-304269","volume":"63","author":"HB El-Serag","year":"2014","unstructured":"El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut NIH Public Access. 2014;63:871. https:\/\/doi.org\/10.1136\/GUTJNL-2012-304269.","journal-title":"Gut NIH Public Access"},{"key":"6606_CR6","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s12664-019-00979-y","volume":"38","author":"SJ Bhatia","year":"2019","unstructured":"Bhatia SJ, Makharia GK, Abraham P, Bhat N, Kumar A, Reddy DN, Ghoshal UC, Ahuja V, Rao GV, Devadas K, Dutta AK. Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology. Indian J Gastroenterol. 2019;38:411\u201340. https:\/\/doi.org\/10.1007\/s12664-019-00979-y.","journal-title":"Indian J Gastroenterol."},{"key":"6606_CR7","doi-asserted-by":"publisher","first-page":"4100","DOI":"10.1007\/s11695-021-05541-4","volume":"31","author":"A Curell","year":"2021","unstructured":"Curell A, Beisani M, Ruiz G, de Gordejuela A, Vilallonga R, Verdaguer Tremolosa M, Gonz\u00e1lez L\u00f3pez \u00d3, et al. Outcomes of conversion from sleeve gastrectomy to roux-en-Y gastric bypass due to GERD\u2014a retrospective analysis of 35 patients. Obes Surg. Obes Surg. 2021;31:4100\u20136. https:\/\/doi.org\/10.1007\/s11695-021-05541-4.","journal-title":"Obes Surg"},{"key":"6606_CR8","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1136\/GUTJNL-2017-314722","volume":"67","author":"C Prakash Gyawali","year":"2018","unstructured":"Prakash Gyawali C, Kahrilas PJ, Savarino E, Zerbib F, Mion F, Smout AJPM, et al. Modern diagnosis of GERD: the Lyon Consensus. 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Obes Surg. 2008;18:1039\u201342. https:\/\/doi.org\/10.1007\/S11695-007-9399-1\/FIGURES\/2.","journal-title":"Obes Surg."},{"key":"6606_CR13","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1097\/SLA.0b013e3181e90b31","volume":"252","author":"J Himpens","year":"2010","unstructured":"Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319\u201324. https:\/\/doi.org\/10.1097\/SLA.0b013e3181e90b31.","journal-title":"Ann Surg."},{"key":"6606_CR14","doi-asserted-by":"publisher","unstructured":"Desprez C, Melchior C, Wuestenberghs F, Huet E, Zalar A, Jacques J, et al. Pyloric distensibility measurement after gastric surgery: which surgeries are associated with pylorospasm? Neurogastroenterol Motil. 2020:32. https:\/\/doi.org\/10.1111\/NMO.13790.","DOI":"10.1111\/NMO.13790"}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-023-06606-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-023-06606-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-023-06606-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T07:05:47Z","timestamp":1687590347000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11695-023-06606-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,28]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["6606"],"URL":"https:\/\/doi.org\/10.1007\/s11695-023-06606-2","relation":{},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"value":"0960-8923","type":"print"},{"value":"1708-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,28]]},"assertion":[{"value":"16 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. No animal studies were performed by any of the authors for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}