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Does Sleeve Gastrectomy Increase the Risk of Barret’s Esophagus?

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Abstract

Purpose

Sleeve gastrectomy (SG) is the most commonly performed bariatric surgical procedure worldwide. However, the impact of SG on Barrett’s esophagus (BE) remains unknown. The main objective was to determine the rate of BE 5 years after SG.

Materials and Methods

Patients, operated in 2012 by SG in one center, who preoperatively and postoperatively (5 years) underwent upper gastrointestinal endoscopy (UGIE), 24-h pH monitoring, and esophageal manometry, were included.

Results

A total of 59 (81.4% of females) patients were included. Preoperative mean age and body mass index were 45.2 ± 11.7 years and 45.2 ± 8.1 kg/m2 respectively. Preoperative 24-h pH monitoring reported gastroesophageal reflux disease (GERD) in 18 (30.5%) patients. The mean total body weight loss at 5 years was 16.1 ± 11.2%. No significant difference was observed between preoperative and postoperative de Meester’s score (20.2 ± 27.1 and 21.0 ± 21.5 respectively (p = 0.91)) nor between preoperative and postoperative number of acid reflux episodes per 24 h (65.1 ± < 40.0 and 50.3 ± 40.3 (p = 0.21)). The UGIE revealed 5 patients (8.5%) with endoscopically suspected esophageal metaplasia, without confirmed metaplasia on histologic examination. GERD was diagnosed in 32 patients (54.2%), de novo GERD in 16 (27.1%) patients and esophagitis in 16 (27.1%) patients. At 5 years, 25 patients (42.4%) reported a lack of regular medical follow-up.

Conclusions

This study highlights the incidence of postoperative GERD and endoscopic lesions following SG. Even though SG is not contraindicated in case of reflux, GERD patients who undergo SG may be supervised by a close endoscopic surveillance.

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Acknowledgments

We thank Nelly Renaud Moreau to the help for collecting data.

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Authors and Affiliations

  1. Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l’Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093, Nantes, France

    L. Lallemand, E. Duchalais, E. Mirallié & C. Blanchard

  2. Université de Nantes, quai de Tourville, 44000, Nantes, France

    E. Duchalais, D. Jacobi, E. Coron, S. Bruley des Varannes, E. Mirallié & C. Blanchard

  3. Service d’Hépato-Gastroentérologie et Assistance Nutritionnelle, Institut des Maladies de l’Appareil Digestif (IMAD), Centre Hospitalo-Universitaire (CHU), Nantes, France

    N. Musquer, E. Coron & S. Bruley des Varannes

  4. L’Institut du Thorax, Service d’Endocrinologie, Maladies Métaboliques et Nutrition, CHU Nantes, Nantes, France

    D. Jacobi & C. Blanchard

  5. L’Institut du Thorax, Inserm UMR-S1087, CNRS, UNIV Nantes, Nantes, France

    D. Jacobi

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Correspondence to C. Blanchard.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was validated by the local Institutional Review Board (Groupe Nantais d’Éthique Dans la Santé) (RC17_0373). All patients signed an informed written consent.

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Lallemand, L., Duchalais, E., Musquer, N. et al. Does Sleeve Gastrectomy Increase the Risk of Barret’s Esophagus?. OBES SURG 31, 101–110 (2021). https://doi.org/10.1007/s11695-020-04875-9

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