Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication

Abstract

In the present series the incidence of EE and of BE in SG patients was considerably higher than that reported in the current literature, and it was not related to GERD symptoms. Endoscopic surveillance after SG should be advocated irrespective of the presence of GERD symptoms.

Consecuencias fisiopatológicas y anatómicas posgastrectomía vertical tubular como posibles causas de enfermedad por reflujo gastroesofágico

“…Hernia Hiatal 11 (5,3%) 27-74% 33,37,38 Estenosis mesogástrica 3 (1,4%) 0,7-3,5% [11][12][13] Radiología (n = 93)…”

“…Reflujo presente 42 (45,2%) 67% 11,33,38 Cardias dilatado 40 (43%) 60% 11,36,37,38 Hernia Hiatal 11 (11,8%) 60,8% 36,37,38 Estenosis mesogástrica 3 (3,2%)* 0,7-3,5 11-13 *bujía 34 French. con respecto a este punto están de acuerdo con las otras experiencias informadas (Tabla 3).…”

Reply to the Letter to the Editor on “Helicobacter Pylori Does Not Affect Postoperative Outcomes after Sleeve Gastrectomy”

“…Data from the literature concerning the development of BE after LSG are scarce. Genco et al [3] showed a very high incidence of BE in LSG patients. Thus, endoscopic evaluation in the postoperative surveillance of LSG patients should be encouraged.…”

Response to: “Are Guidelines for Standardized Outcome Reporting in Bariatric Surgery Responsible for Missing the Big Picture in Bariatric Surgery Related Major Complications?”

“…Furthermore, the long-term issue of gastroesophageal reflux after sleeve has to be taken into account when discussing the safety of the 2 procedures. In a recent article by Genco et al, 6 17% of 110 asymptomatic patients showed signs of Barrett's esophagus after a mean of 58 months postsleeve. In other words, although the long-term side effects of the bypass procedures are well documented, as the first bypass procedures were performed over 50 years ago, we still do not know all possible side effects of sleeve gastrectomy yet.…”

“…5 Till now, no validated score for late complications exists. However, the numbers mentioned by Fysekidis et al 6 for ''reoperations for major complications'' are incorrect. In the sleeve group, 2 patients had to be converted to bypass because of severe reflux, and another 2 were reoperated for insufficient weight loss as compared with 6 patients in the bypass group that were reoperated until 3 years postoperation (internal hernia, bowel obstruction, and insufficient weight loss).…”