Erosive esophagitis after bariatric surgery: banded vertical gastrectomy versus banded Roux-en-Y gastric bypass

Obesity is associated with gastroesophageal reflux disease. Roux-en-Y gastric bypass is the most performed bariatric procedure in the world, whereas sleeve gastrectomy is an emerging procedure. Both can be combined with the use of a Silastic® ring. The aim of this study was to compare the evolution of erosive esophagitis (EE) in patients who underwent Silastic® ring gastric bypass (SRGB) and Silastic® ring sleeve gastrectomy (SRSG) after a 1-year postoperative period.

We carried out a non-randomized, prospective, controlled clinical study. Sixty-five patients were enrolled based on the following inclusion criteria: female gender, age 20-60 years old, BMI 40-45 and written informed consent. The exclusion criteria were secondary obesity, alcohol or drug use, severe psychiatric disorder, binge-eating of sweets, and previous stomach or bowel surgery. The patients were divided into two groups-33 (51%) underwent SRSG and 32 (49%) patients underwent SRGB. All patients underwent an esophago-gastro-duodenoscopy during the preoperative period and at 12-14 months after the surgery.

Preoperatively, 15 patients (23.8%) were found to have EE, six (19.4%) in the SRSG group and nine patients (28.1%) in the SRGB group (p = 0.7795). Postoperatively, there was an increase in the number of patients with EE in the SRSG group to 14 (45.2%) and a decrease in the SRGB group to two (6.3%), giving a total of 16 patients with EE (25.4%; p = 0.0007).

After 1 year of follow-up, we observed a worsening evolution of EE in the SRSG group, but improvement in the SRGB group.