Endoscopic findings and gastroesophageal reflux changes after sleeve gastrectomy: Results of 18-month follow-up

INTRODUCTION: Obesity is now a critical public health challenge globally. Laparoscopic Sleeve Gastrectomy (LSG) is a widely performed obesity surgery known for its effectiveness in promoting weight loss and improving obesity-related conditions. The aim of study was to assess the presence of gastroesophageal reflux symptoms (GERD) symptoms after LSG.
METHODS: This retrospective observational study included patients who underwent LSG for morbid obesity between October 2022 and March 2024. Demographic characteristics, body mass index (BMI), percentage of excess weight loss (%EWL), and comorbidities were assessed preoperatively and at 6, 12, and 18 months postoperatively. Esophagogastroduodenoscopy (EGD) was performed before surgery and at the 18-month follow-up.
RESULTS: Eighty-six patients met the inclusion criteria (52 females, 60.4%), with a mean age of 39±8 years. Mean preoperative BMI was 43.8±14 kg/m², which decreased to 28.6±6 kg/m² at 18 months, corresponding to a mean %EWL of 61±8.4%. Preoperative GERD symptoms were present in 19 patients (22.1%), increasing to 25 (29.1%) postoperatively (p>0.05). EE was identified in 14 patients (16.2%) before surgery and in 25 patients (29.1%) after surgery (p<0.001). De novo EE developed in 22 patients (25.5%), mostly Grade A (72.7%). HH prevalence increased from 20.9% to 30.2% (p<0.001).
DISCUSSION AND CONCLUSION: In summary, our 18-month follow-up demonstrated an increase in gastroesophageal reflux and endoscopic evidence of esophagitis after sleeve gastrectomy.

Keywords: Erosive esophagitis, gastroesophageal reflux symptoms, hiatal hernia, laparoscopic sleeve gastrectomy, obesity