Concomitant Obesity and GERD: Is Laparoscopic Sleeve Gastrectomy Still Considered the Best Option? A Clinical and Endoscopic Evaluation
Ehab M Oraby, Ola A Harb, Mokhtar A Bahbah
Body mass index, Gastroesophageal reflux disease, Obesity, Sleeve gastrectomy
Citation Information :
Oraby EM, Harb OA, Bahbah MA. Concomitant Obesity and GERD: Is Laparoscopic Sleeve Gastrectomy Still Considered the Best Option? A Clinical and Endoscopic Evaluation. World J Lap Surg 2022; 15 (3):266-271.
Background: Obesity is a real worldwide problem. About one billion people are suffering from obesity all over the world. Two-thirds of the communities are adults, then the remaining one-third are children and adolescents. Obese patients especially those with central obesity are showing an incidence of 20–50% for preexisting gastroesophageal reflux disease (GERD). Objectives: This article is trying to define the relationship between these items in obese patients in our community through clinical and endoscopic evaluation. Patients and methods: This prospective study involved 61 patients who were scheduled for bariatric procedures. All patients were invited to answer a GERD questionnaire and to do upper GI endoscopy twice: once preoperative and second time 1 year postoperatively. Patients were divided into three groups regarding preexisting GERD and operative procedure. Results: Group A patients showed significant worsening of GERD scores, endoscopic esophagitis grade, and proton pump inhibitor dependency (PPI). Group B patients showed significant improvement in GERD scores without improvement in esophagitis grade. Group C patients showed multifactorial significant improvement. Conclusion: Laparoscopic sleeve gastrectomy (LSG) operation seems to be truly a refluxogenic procedure, while Roux-En-Y gastric bypass (RYGB) should be considered as better alternatives to avoid postoperative worsening of GERD and degree of esophagitis. These results need confirmation by studies with a bigger number of patients.
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