EAES Academy

Background:

Sleeve gastrectomy became one of the most commonly performed bariatric procedure. There is an increasing that sleeve gastrectomy patients suffer from gastroesophageal reflux disease and its sequel such as erosive esophagitis or Barret’s oesophagus.

Furthermore, several studies indicate that visceral adiposity and metabolic syndrome, which are frequently present in patients undergoing bariatric procedures, contribute to the development of BE irrespective of the presence of GERD.

In our study we aim to evaluate the incidence of erosive esophagitis and Barrett’s esophagus among patients with normal preoperative esophagogastroduodenoscopy findings who underwent sleeve gastrectomy and investigate factors which may contribute to the development of EE and BE after the surgery.
Methods:

We conducted a single centre longitudinal study which included patients who underwent sleeve gastrectomy and completed 5 years follow up period. Gastroscopies were performed in all patients at the end of the follow up period. Patients’ and treatment related factors were used to search for risk factors of Barrett’s oesophagus

Results:

From a total of 30 patients, symptomatic reflux was reported by 17 patients (56.7%) during the follow up period. At OGD erosive oesophagitis was found in nine of those patients (30%), whereas BE was diagnosed in eight patients (27%). The median BMI at the end of the follow up period was significantly higher among patients with BE than in the groups with EE and with no endoscopic changes, 40.91±6.32, 32.42±5.53 and 33.25±4.41 respectively (p = 0.04).

Conclusions:

The prevalence of Barret oesophagus in SG patients is considerable. The risk of BE increases in patients with poor bariatric outcome. Endoscopic surveillance should be considered as part of the follow-up especially in patients with the higher overall risk of BE.