GERD Reduction Overestimated After Gastric Bypass GERD Reduction Overestimated After Gastric Bypass
Gastric bypass surgery relieved symptoms of gastroesophageal reflux disease in only approximately half of patients with severe obesity, a study found.Medscape Medical News
ConclusionsForegut pathology is common in bariatric patients with subjective symptoms of GERD. Implementing a comprehensive protocol to objectively assess these patients leads to a significant clinical impact on which procedure these patients ultimately undergo.
This study included patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). The primary outcome of interest was incisional SSI occurring within 30 days. Surgeries performed in 2015 were used in a derivation cohort and the predictive tool was validated against the 2016 cohort. A forward selection algorithm was used to build a logistic regression model predicting probability of SSI.ResultsA total of 274,187 patients were included with 71.7% being LSG and 28.3% LRYGB. 0.7% of patients had a SSI in which 71.0% had an incisional SSI, and 29.9% had an organ/spa...
One anastomosis gastric bypass (OAGB) is an accepted bariatric and metabolic surgery with certain important complications such as post-operative gastroesophageal reflux disease (GERD) and bile reflux (BR), which are not well addressed in literature.
ConclusionA tailored HIDA scan protocol with addition of a SPECT-CT scan, ingestion of a fatty meal and prolonged scanning duration results in enhanced bile reflux detection in post-bariatric surgical patients.
The main side effect of long-term laparoscopic sleeve gastrectomy (LSG) is the onset of severe gastroesophageal reflux disease (GERD).
ConclusionsComparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.
AbstractObjectiveTo evaluate the impact of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) in patients with obesity.MethodsPatients with class II or III obesity were treated with LSG or LRYGB. Procedure choice was based on patients and surgeon preferences. GERD symptoms, endoscopy, barium swallow X-ray, esophageal manometry, and 24-h pH monitoring were obtained before and 1 year after surgery.ResultsSeventy-five patients underwent surgery (83% female, 39.3 ± 12.1 years, BMI of 41.5 ± 5.1 kg/m2): 35 (46.7%) had LSG and 40 (53.3%) ...
AbstractPurpose of reviewBariatric surgery and endoluminal bariatric therapies (EBTs) form an increasingly utilized therapeutic approach to treat obese patients but may worsen gastroesophageal reflux disease (GERD). In this updated article, we review the evidence on the effects of bariatric procedures on GERD.FindingsRecent evidence implicates sleeve gastrectomy with the highest rates of de novo GERD and Barrett ’s esophagus (BE), whereas malabsorptive-restrictive procedures such as Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) were shown to have significantly lower reported rates. The int...
ConclusionsBoth LRYGB and LSG have comparative effect on resolving T2DM in nonseverely obese patients at midterm follow-up. Further RCTs should address the potential risks and long-term effects of LRYGB and LSG in nonseverely obese patients.
ConclusionLBPD/DS or DJB as revision surgery appears to be effective for further weight loss in the medium term, and LRYGB appears to be effective for GERD remission. Bariatric surgeons should bear in mind, however, that the post-LRYGB complication rate appears to be relatively high.