Roux-en-Y Gastric Bypass as a Treatment for Barrett's Esophagus after Sleeve Gastrectomy.

Obes Surg 2020 Apr;30(4):1273-1279

Division of General Surgery, Department of Surgery, Vienna Medical University, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Background: Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure today. While an increasing number of long-term studies report the occurrence of Barrett's esophagus (BE) after SG, its treatment has not been studied, yet.

Objectives: The aim of this study was to evaluate Roux-en-Y gastric bypass (RYGB) as treatment for BE and reflux after SG.

Setting: University hospital setting, Austria METHODS: This multi-center study includes all patients (n = 10) that were converted to RYGB due to BE after SG in Austria. The mean interval between SG and RYGB was 42.7 months. The follow-up after RYGB in this study was 33.4 months. Gastroscopy, 24 h pH-metry, and manometry were performed and patients were asked to complete the BAROS and GIQLI questionnaires.

Results: Weight and BMI at the time of SG was 120.8 kg and 45.1 kg/m. Eight patients (80.0%) went into remission of BE after the conversion to RYGB. Two patients had RYGB combined with hiatoplasty. The mean acid exposure time in 24 h decreased from 36.8 to 3.8% and the mean DeMeester score from 110.0 to 16.3. Patients scored 5.1 on average in the BAROS after conversion from SG to RYGB which denotes a very good outcome.

Conclusions: RYGB is an effective therapy for patients with BE and reflux after SG. Its outcomes in the current study were BE remission in the majority of cases as well as a decrease in reflux activity. Further studies with larger cohorts are necessary to confirm these findings.

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Source
http://dx.doi.org/10.1007/s11695-019-04292-7DOI Listing
April 2020

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