Michael Weitzendorfer, Eva Johanna Wallner, Charlotte Rabl, Klaus Emmanuel, Oliver Owen Koch
{"title":"586. VALUE OF PEPSIN IN SALIVA TO ASSESS THE POSTOPERATIVE OUTCOME OF PATIENTS WITH GERD","authors":"Michael Weitzendorfer, Eva Johanna Wallner, Charlotte Rabl, Klaus Emmanuel, Oliver Owen Koch","doi":"10.1093/dote/doae057.306","DOIUrl":null,"url":null,"abstract":"Background The aim of this study was to evaluate the value of salivary pepsin to assess the outcome of surgical treatment of patients with gastroesophageal reflux (GERD). Methods Forty-five consecutive patients with GERD despite proton pump inhibitor treatment received laparoscopic anti-reflux surgery (LARS). 24-hour esophageal pH-monitoring (MII-pH) and esophageal manometry (HRM) data were documented preoperatively and at 3-month follow-up. Clinical symptoms were rated with the Gastrointestinal Quality of Life Index (GIQLI) and gastrointestinal symptoms were evaluated by a standardized symptom checklist (SCL), assessing the severity and intensitiy of 14 different symptoms. Simultaneous to MII-pH the collection of 3 saliva samples per patient was performed. Treatment failure was defined as improvement of GIQLI and SCL of < 10 points, despite showing a normal DeMeester score. Results At baseline, all patients showed a pathological MII-pH measurement. Furthermore, all patients showed postoperatively a normal DeMeester score (mean 7.10 ± 4.56). Ten patients were defined as treatment failures with a change of pepsin concentration from a mean value of 198.73 ng/mL to 186.00 ng/mL (p>0.05). In patients defined as treatment success, mean pepsin value decreased from 205.83 ng/mL to 85.24 ng/mL (p<0.001). Conclusion Salivary pepsin could be a marker for treatment success after LARS. However, larger studies are required to reach firm conclusions.","PeriodicalId":11354,"journal":{"name":"Diseases of the Esophagus","volume":"44 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diseases of the Esophagus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/dote/doae057.306","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background The aim of this study was to evaluate the value of salivary pepsin to assess the outcome of surgical treatment of patients with gastroesophageal reflux (GERD). Methods Forty-five consecutive patients with GERD despite proton pump inhibitor treatment received laparoscopic anti-reflux surgery (LARS). 24-hour esophageal pH-monitoring (MII-pH) and esophageal manometry (HRM) data were documented preoperatively and at 3-month follow-up. Clinical symptoms were rated with the Gastrointestinal Quality of Life Index (GIQLI) and gastrointestinal symptoms were evaluated by a standardized symptom checklist (SCL), assessing the severity and intensitiy of 14 different symptoms. Simultaneous to MII-pH the collection of 3 saliva samples per patient was performed. Treatment failure was defined as improvement of GIQLI and SCL of < 10 points, despite showing a normal DeMeester score. Results At baseline, all patients showed a pathological MII-pH measurement. Furthermore, all patients showed postoperatively a normal DeMeester score (mean 7.10 ± 4.56). Ten patients were defined as treatment failures with a change of pepsin concentration from a mean value of 198.73 ng/mL to 186.00 ng/mL (p>0.05). In patients defined as treatment success, mean pepsin value decreased from 205.83 ng/mL to 85.24 ng/mL (p<0.001). Conclusion Salivary pepsin could be a marker for treatment success after LARS. However, larger studies are required to reach firm conclusions.