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

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Gastroesophageal Reflux Disease

Background:

• Sleeve gastrectomy (SG) is a prevalent bariatric procedure.
• The effect of SG on Barrett's esophagus (BE) is not well-established.
• Understanding post-SG esophageal changes is crucial for patient management.

Purpose of the Study:

• To determine the rate of Barrett's esophagus (BE) 5 years after sleeve gastrectomy (SG).
• To evaluate the incidence of gastroesophageal reflux disease (GERD) and esophagitis post-SG.

Main Methods:

• A cohort of 59 patients undergoing SG in 2012 were assessed.
• Preoperative and 5-year postoperative upper gastrointestinal endoscopy (UGIE), 24-h pH monitoring, and esophageal manometry were performed.
• Body weight loss and de Meester scores were analyzed.

Main Results:

• No significant difference in de Meester scores or acid reflux episodes was found pre- and post-SG.
• 5 patients (8.5%) had suspected esophageal metaplasia, but none were confirmed histologically.
• Post-SG, 54.2% were diagnosed with GERD, 27.1% with de novo GERD, and 27.1% with esophagitis.

Conclusions:

• Sleeve gastrectomy (SG) does not appear to directly cause Barrett's esophagus (BE).
• SG is associated with a high incidence of postoperative gastroesophageal reflux disease (GERD) and esophagitis.
• Patients undergoing SG, especially those with pre-existing GERD, require close endoscopic surveillance.