AB010. OP-10 Gastroesophageal reflux disease after sleeve gastrectomy—incidence and effectiveness of technical modifications
Abstract

AB010. OP-10 Gastroesophageal reflux disease after sleeve gastrectomy—incidence and effectiveness of technical modifications

Ozan Şen1, Fatih Can Karaca2, Ahmet Gökhan Türkçapar1

1Türkçapar Bariatrics, Istanbul, Turkey; 2İstanbul Surgery Hospital, Istanbul, Turkey

Correspondence to: Ozan Şen. Türkçapar Bariatrics, Istanbul, Turkey. Email: ozansen77@hotmail.com.

Background: Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgical procedure in the world, but gastroesophageal reflux disease (GERD), which is observed up to a ratio of 30% following the LSG is an important problem. The aim of this study was to share the incidence of preoperative and postoperative GERD in our LSG series, and a novel LSG technique designed to prevent GERD formation during the follow-up period in selected patients with preoperative reflux.

Methods: Patients who underwent LSG for morbid obesity and completed one-year follow-up duration were included. Each patient underwent preoperative endoscopy. Postoperatively, all patients received routine PPI treatment for 6 months. After six months following the procedure, PPI was discontinued, and patients were evaluated for reflux symptoms. Patient data were recorded prospectively and evaluated retrospectively.

Results: LSG was performed on 750 patients with a mean age of 38.1 (56.4% female) with a mean BMI of 43.6 kg/m2 between 2013 and 2018. The mean follow-up was 3.4 years (1–6 years). Preoperative endoscopy revealed La-a/b esophagitis in 260 patients (35%). Seventy (27%) of the patients with esophagitis had preoperative reflux complaints. Hiatal hernia was detected in 109 patients (12%). De-novo GERD incidence after LSG was determined as 10% in our series. Symptomatic GERD developed in 50 out of 260 patients with preoperative esophagitis and continued to use PPI in the follow-up (7%). Seventy (70%) of the patients with preoperative reflux complaints and esophagitis on endoscopy did not report any signs of GERD at the follow-up.

Conclusions: GERD after LSG is an important problem in long-term follow-up. Obesity alone is an independent risk factor for GERD formation. A significant proportion of patients with preoperative symptomatic reflux can recover after the weight loss. Modified LSG techniques to reduce the incidence of GERD may be effective in selected cases.

Keywords: Obesity; laparoscopic sleeve gastrectomy (LSG); gastroesophageal reflux disease


Footnote

Provenance and Peer Review: This abstract is included in “Abstracts from the 3rd Turkish National Congress on Bariatric and Metabolic Surgery, 21st-24th November 2019, Antalya-Turkey”, which is commissioned by the Guest Editor (Mehmet Mahir Özmen) for the series “Bariatric and Metabolic Surgery” published in Annals of Laparoscopic and Endoscopic Surgery. This abstract did not undergo external peer review.

Conflicts of Interest: The authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/ales-2019-bms-21). The series “Bariatric and Metabolic Surgery” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

doi: 10.21037/ales-2019-bms-21
Cite this abstract as: Şen O, Karaca FC, Türkçapar AG. OP-10 Gastroesophageal reflux disease after sleeve gastrectomy—incidence and effectiveness of technical modifications. Ann Laparosc Endosc Surg 2020;5:AB010.