World Journal of Laparoscopic Surgery

Register      Login

VOLUME 15 , ISSUE 3 ( September-December, 2022 ) > List of Articles

CLINICAL TECHNIQUE

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

Keywords : 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.

DOI: 10.5005/jp-journals-10033-1517

License: CC BY-NC 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

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.


HTML PDF Share
  1. Daher HB, Sharara AI. Gastroesophageal reflux disease, obesity, and laparoscopic sleeve gastrectomy: the burning questions. World J Gastroenterol 2019;25(33):4805–4813. DOI:10.3748/wjg.v25.i33.4805.
  2. Navarini D, Madalosso CAS, Tognon AP, et al. Predictive factors of gastroesophageal reflux disease in bariatric surgery: a controlled trial comparing sleeve gastrectomy with gastric bypass. Obes Surg2020;30(4):1360–1367. DOI:10.1007/s11695-019-04286-5.
  3. Vilallonga R, Sanchez-Cordero S, Umpiérrez Mayor N, et al. Gerd after bariatric surgery. Can we expect endoscopic findings? Medicina (Lithuania) 2021;57(5). DOI:10.3390/medicina57050506.
  4. El Chaar M, Ezeji G, Claros L, et al. Short Term Results of Laparoscopic Sleeve Gastrectomy in Combination with Hiatal Hernia Repair. OBES SURG 2016;26:68–76.
  5. DuPree CE, Blair K, Steele SR, et al. Laparoscopic sleeve gastrectomy in patients with preexisting gastroesophageal reflux disease: a national analysis. JAMA Surg 2014;149(4):328–334. DOI: 10.1001/jamasurg.2013.4323.
  6. Lye TJY, Ng KR, Tan AWE, et al. Small hiatal hernia, and postprandial reflux after vertical sleeve gastrectomy: a multiethnic Asian cohort. PLoS One 2020;15(11):e0241847. DOI: 10.1371/journal.pone.0241847.
  7. Naeem Z, Yang J, Park J, et al. A step in the right direction trends over time in Bariatric procedures for patients with gastroesophageal reflux disease. Obes Surg 2020;30(11):4243–4249. DOI: 10.1007/s11695-020-04776-x.
  8. Saba J, Bravo M, Rivas E, et al. Incidence of de novo hiatal hernia after laparoscopic sleeve gastrectomy. Obes Surg 2020;30(10):3730–3734. DOI: 10.1007/s11695-020-04742-7.
  9. Braghetto I, Korn O, Burgos A, et al. When should be converted laparoscopic sleeve gastrectomy to laparoscopic roux-en-y gastric bypass due to gastroesophageal reflux? Arq Bras Cir Dig 2020;33(4):1–6. DOI:10.1590/0102-672020200004e1553.
  10. Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett's esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg 2017;27(12):3092–3101. DOI:10.1007/s11695-017-2748-9.
  11. Castelijns, et al. GERD-health related quality of life questionnaire (GERD-HRQL). J Minimal Access Surg 2018;14(3).
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.