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Updated: May 13, 2026
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A Protocol for Roux-en-Y Gastric Bypass in Rats using Linear Staplers
Published on: August 21, 2021
Conversion to Roux-en-Y gastric bypass as an effective treatment for postsleeve reflux: Identifying risk factors for
Agustina A Pontecorvo1, Jorge Cornejo1, Tamar Tsenteradze1
1Division of Advanced Gastrointestinal and Bariatric Surgery, Department of General Surgery, Mayo Clinic, Jacksonville, FL, USA.
Summary
Sleeve angulation is a key factor for persistent GERD after gastric bypass revision. Identifying high-risk patients preoperatively improves outcomes for GERD following sleeve gastrectomy to Roux-en-Y gastric bypass conversion.
Area of Science:
- Bariatric surgery outcomes
- Gastroenterology and digestive health
Background:
- Roux-en-Y gastric bypass (RYGB) is the preferred revisional surgery for gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG).
- While effective for many, a significant portion of patients experience persistent GERD post-conversion.
- Limited data exists on factors predicting refractory GERD after SG to RYGB.
Purpose of the Study:
- To identify predictors of persistent GERD symptoms after converting from SG to RYGB.
- To inform patient selection and preoperative counseling for this complex procedure.
Main Methods:
- Retrospective review of 109 patients undergoing SG to RYGB conversion (2013-2024).
- Assessment of preoperative GERD, esophagitis, sleeve anatomy, and PPI use.
- Univariate and multivariate regression analyses to determine factors associated with persistent reflux.
Main Results:
- 75.5% of patients achieved reflux resolution and discontinued PPIs post-conversion.
- 24.5% experienced persistent GERD requiring maximum-dose PPI.
- Sleeve angulation (OR 6.2), preoperative GERD (OR 2.7), dysphagia (OR 3.9), and twice-daily PPI use (OR 2.6) predicted persistent reflux.
- Conversion for weight regain was protective (OR 0.27).
Conclusions:
- Persistent GERD after SG to RYGB conversion is a significant clinical issue.
- Preoperative identification of sleeve angulation and GERD history is crucial.
- Optimizing patient selection and counseling is essential for managing refractory GERD.
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