The Protective Effect of Transit Bipartition and Its Modification Against Sleeve Gastrectomy-Related Esophagitis in a Rodent Model

Feb 1, 2022Obesity surgery

How Transit Bipartition May Reduce Acid Reflux Caused by Sleeve Gastrectomy in Rats

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Abstract

Postoperatively, the SG-PTB and SG-TB groups showed significantly superior glucose control compared to the SG group (p < 0.05).

No significant differences were found in food intake, body weight, or fasting blood glucose levels among the groups before surgery.
Postoperative GLP-1 levels were higher in the SG-PTB and SG-TB groups compared to the SG and SHAM groups.
The SG group exhibited more severe esophageal hyperpapillomatosis compared to the SG-PTB and SG-TB groups.
Mucosal height was significantly greater in the SG group than in the SG-PTB, SG-TB, and SHAM groups (p < 0.05).
The transit bipartition procedure may protect the distal esophagus from changes associated with esophagitis.

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BACKGROUND: The protective effect of transit bipartition against esophagitis has not yet been proven. Thus, we investigate and compare the bariatric outcomes and esophagus' histological changes of sleeve gastrectomy (SG), SG with transit bipartition (SG-TB), and the proximal SG-TB (SG-PTB) in a rodent model.

METHODS: This study included 45 diabetic Sprague-Dawley rats assigned to one of the four groups, SG-PTB (n = 15), SG-TB (n = 12), SG (n = 10), and SHAM (n = 8). Eight surviving rats from each group were included for further investigation. Histological analysis of the gastroesophageal junction was performed. Body weight, food intake, glucose control, and hormonal changes (glucagon-like peptide-1 and insulin) were assessed before and after surgery in all groups.

RESULTS: Preoperatively, no significant differences were observed in food intake, body weight, and fasting blood glucose levels among the groups. Postoperatively, the SG-PTB and SG-TB groups showed significantly superior glucose control compared to the SG group following the gavage of glucose (p < 0.05). Postoperatively, the SG-PTB and SG-TB groups had higher postoperative GLP-1 levels than postoperative SG and SHAM groups. More severe esophageal hyperpapillomatosis (EHP) of the esophageal section was observed in the SG group. The mucosal height of the SG group was significantly higher than that of the SG-PTB, SG-TB, and SHAM groups (p < 0.05).

CONCLUSION: The transit bipartition procedure may protect the distal esophagus from histological changes associated with esophagitis. Clinical studies are needed to confirm the anti-reflux effects of transit bipartition.

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The Protective Effect of Transit Bipartition and Its Modification Against Sleeve Gastrectomy-Related Esophagitis in a Rodent Model

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