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THE ASSOCIATION BETWEEN PREOPERATIVE ENDOSCOPIC ESOPHAGITIS AND POST OPERATIVE GERD IN SLEEVE GASTRECTOMY PATIENTS

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).

Table I. Group Baseline 
  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.

Table II. Post-op PPI Dependency
  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

45

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