Patrick E LeMasters, MD, Lindsay Cumella, BS, J Choi, MD, P Vemulapalli, MD, S Melvin, MD, D Camacho, MD. Montefiore Medical Center
Introduction: The objective of this study is to analyze the effect of gastric bypass (GB) and sleeve gastrectomy (SG) on patients with preoperative gastroesophageal reflux disease (GERD).
Methods: We retrospectively reviewed the charts of patients that had bariatric surgery from 2009 to 2013 to identify those with preoperative GERD. The charts were then examined at 1 year postoperatively to identify the status of their GERD symptoms. This was evaluated to be worse, not changed, improved, or resolved and given respective scores of 1,2,3, or 4. We then compared results of these outcomes between sleeve gastrectomy and gastric bypass and determined statistical significance using an unpaired student t-test.
Results: 900 laparoscopic bariatric cases were reviewed. Preoperative GERD was found in 123 patients. 82 of these patients had gastric bypass and 41 had sleeve gastrectomy. 52 gastric bypass and 29 sleeve gastrectomy patients had follow up at one year to evaluate symptoms postoperatively . The GB group had significantly improved post op symptoms of their GERD (3.04 vs 2.551 p = 0.019). Complete resolution of symptoms occurred in 18/52 (36%) of LGB and 5/29 (17%) of SG patients. Improved symptoms occurred in 19/52 (36.5%) of LGB and 10/29 (34%) of SG patients. 14/52 (27%) of GB and 10/29 (34%) of LSG had no change in symptoms. 1/52 (1.9%) and 4/29 (13.7%) had worse symptoms. 37/52 (71.1%) had improved or completely resolved after GB while 15/29 (51%) improved or resolved after LSG.
Conclusion: Gastric bypass may lead to better resolution and improvement of preoperative GERD compared to Sleeve gastrectomy.