Efficacy evaluation of pepsin in laparoscopic antireflux surgery for gastroesophageal reflux disease

Abstract

BACKGROUND:

The false positive rate of the PPI test for the diagnosis of typical symptoms of gastroesophageal reflux disease (GERD) is extremely high.

OBJECTIVE:

This study aims to investigate the effect of the pepsin test on GERD and laparoscopy-assisted anti-reflux surgery for GERD.

METHODS:

A total of 30 GERD patients were enrolled into this study, and the pre-diagnosis of GERD was determined by symptom evaluation, impedance-pH examination, gastroscopy and pepsin test. All patients underwent surgery.

RESULTS:

Among the 30 GERD patients, 18 patients were male and 12 were female, and their average age was 58.2 $+$ 12.6 years old. The patients were treated with laparoscopic fundoplication and hiatus hernia repair after preoperative assessment. A total of 28 patients were followed up, one patient developed recurrent symptoms, and one patient developed postoperative dysphagia and received non-operative treatment. Furthermore, the symptom scores were significantly lower at postoperative pepsin detection when compared to the scores before the operation (pepsin: preoperative: 148.8 $\pm$ 82.6, postoperative: 30.7 $\pm$ 24.6; $t=$ 4.848, $P=$ 0.000).

CONCLUSIONS:

Laparoscopic fundoplication and hiatus hernia repair may effectively control the symptoms of GERD. Furthermore, the detection of pepsin is non-invasive and easy to operate.