Samer Elkassem, MD. Medicine Hat Regional Hospital
INTRODUCTION: GERD is a common complication after sleeve gastrectomy (SG). The purpose of this study is assess the relationship between pre-operative findings of endoscopic esophagitis and post-operative GERD in SG patients. The hypothesis of this study is that patients with pre-op esophagitis are more likely to have GERD post-op than patients with no esophagitis pre-op.
METHODS: A retrospective review of 103 SG patients who had pre-operative endoscopy and followed prospectively for at least one year was preformed. Patients were divided into two groups based on pre-op endoscopic findings: those with no findings of esophagitis (NE), and those with endoscopic esophagitis, including Barretts (EE). Patients were followed for at least one year, and assessed for usage of a proton pump inhibitor (PPI) usage. The two groups were compared using both student t-test and chi square test.
RESULTS: A total of 63 patients did not have any findings of esophagitis on pre-op endoscopy (NE group), and 38 patients had findings of endoscopic esophigitis (EE). There was no difference in pre-operative demographics and post-op weight loss at one year (Table I).
| NE | EE | p-value | |
| Age |
45.78 |
48.24 |
0.31 |
| BMI |
48.74 |
51.04 |
0.28 |
|
% PPI usage |
30% | 31.5% | 0.92 |
| % weight loss at one year | 27% | 27% | 0.84 |
| % Hiatal hernia repair | 4.7% | 15.7% | 0.1 |
Follow-up ranged from one to 4 years post-op. The dependency on PPI usage and de novo reflux are shown in Table II.
| NE | EE | p-value | |
| % PPI usage post-op | 36.5% | 36.7% | 0.97 |
| De novo GERD post-op | 20.9% | 23% | 0.83 |
| Resolved GERD | 15.7% | 33.3% | 0.25 |
CONCLUSIONS: GERD and PPI dependency are common after SG. Patients with pre-op endoscopic esophagitis do not have a higher rate of PPI dependency post-op compared to patients who had no signs of pre-op esophagitis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88380
Program Number: P611
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster