Luciano J Deluca, MD, Patrcio J Cal, MD, Tomas C Jakob, MD, Martin Pruss, MD, Ezequiel O Fernandez, MD. CMPFA Churruca Visca
Introduction: Obesity is associated with multiple metabolic disorders and is a risk factor for several upper gastrointestinal tract diseases. GERD’s prevalence can rise to 49.6% in the obese population.
Controversy has arisen regarding the severity of esophageal reflux after the one anastomosis gastric bypass (OAGB).
The objective of this study was to evaluate GERD following SAGB.
Methods: Between April 2015 and March 2018, 66 OAGBs were performed either laparoscopically or with robotic assistance.
Patients with at least 1 year follow up were evaluated via a standardized reflux questionnaire (GERDq), upper GI endoscopy and 24 hour pH-impedanciometry performed and interpreted by surgical team to assess acid and non-acid esophageal reflux.
Results were shown as means ± standard deviations or as percentage of the total.
Results: A total of 51 patients achieved 1 year follow-up. Mean age was 45.4 ± 8.1 years, BMI 46.7 ± 7 kg/m2; 59,1% were women. GERD q was obtained in 33 patients, with a mean score of 1.43 ± 2.8. Only one patient showed a result higher than 8.
Upper GI endoscopy was performed on 31. Compared to preoperative study, 1 patient showed resolution of esophagitis, and de novo esophagitis was assesed in 2. No other erosive changes were recorded.
19 patients underwent ph-impedanciometry. Average Demeester score was 6,7±1.8. 5 patients presented a score between 14.7 and 18,7. All of them showed a GERDq of 0 and non erosive upper GI endoscopy.
Average total time with acid reflux was 1,84%, all patients were below 6%. Four patients showed higher than normal number of weakly alkaline episodes, although percentage of total time in alkaline reflux was normal in all studies (0,36%±0,9). All of them presented a GERDq of 0 and a normal upper GI endoscopy. Only one patient showed a positive symptomatic index (SI).
Conclusion: OAGB seems to result in a low incidence of GERD. Even though 6,45% showed to have de novo esophagitis, pH-impedanciometry and questionnaires showed promising results.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95800
Program Number: P184
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster