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Endoscopic Evaluation of De Novo Esophagitis and Barrett’s Esophagus, 5 Years After Sleeve Gastrectomy

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Abstract

Purpose

Sleeve gastrectomy (SG) is the most common bariatric procedure worldwide. It has been reported that there is a strong association between SG and the development of gastroesophageal reflux disease (GERD) and Barrett’s esophagus (BE). This study was conducted to evaluate esophagogastroduodenoscopy (EGD) findings in patients with a history of SG with more than 5-year follow-up.

Methods

This is a retrospective cohort study of prospectively maintained database. Inclusion criteria included patients who underwent SG between April 2015 and March 2016, aged 18 and above, BMI ≥ 40 kg/m2. Patients with 5 years of follow-up were invited to take part in the study and underwent EGD and biopsy.

Results

One hundred twenty-six patients were recruited with a mean age of 44.6 ± 11.1 years. After a 5-year follow-up, there were 31 (29.5%) patients with reflux esophagitis. The grades of GERD were A, B, and C in 16 (15.2), 12 (11.4), and 3 (2.9%) patients, respectively. Incidence of BE was 5.7% after 5 years from SG. There was a 16.6% lost to follow-up at 5 years after SG.

Conclusion

The diagnosis and severity of GERD and the search for BE justify endoscopic surveillance in all long-term post-sleeve patients, regardless of reflux symptoms.

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Data Availability

The authors confirm that the data supporting the findings of this study are available within the article.

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Author information

Authors and Affiliations

  1. Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Kermansaravi, Amir Zare, Foolad Eghbali & Abdolreza Pazouki

  2. Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-E Rasool Hospital, Tehran, Iran

    Mohammad Kermansaravi, Foolad Eghbali & Abdolreza Pazouki

  3. Taunton and Somerset Foundation Trust, Taunton, UK

    Bassem Amr

  4. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran

    Ali Kabir & Amir Zare

  5. Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Seidamir Pasha Tabaeian

  6. Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran

    Seidamir Pasha Tabaeian

  7. Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France

    Radwan Kassir

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  1. Mohammad Kermansaravi
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  2. Bassem Amr
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Key Points

- EGD should be performed in all patients after SG irrelevant to GERD symptoms.

- De novo GERD and BE are important findings after SG.

- EWL% has no correlation with the presence of BE.

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Kermansaravi, M., Amr, B., Kabir, A. et al. Endoscopic Evaluation of De Novo Esophagitis and Barrett’s Esophagus, 5 Years After Sleeve Gastrectomy. OBES SURG 33, 256–262 (2023). https://doi.org/10.1007/s11695-022-06403-3

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