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Obesity Surgery
Published in: Obesity Surgery 9/2021

01-09-2021 | Esophagography | Original Contributions

Outcomes of Conversion from Sleeve Gastrectomy to Roux-en-Y Gastric Bypass Due to GERD—a Retrospective Analysis of 35 Patients

Authors: Anna Curell, Marc Beisani, Amador García Ruiz de Gordejuela, Ramon Vilallonga, Mireia Verdaguer Tremolosa, Óscar González López, Enric Caubet Busquet, José Manuel Fort López-Barajas

Published in: Obesity Surgery | Issue 9/2021

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Abstract

Background

Sleeve gastrectomy (SG) has become one of the most performed bariatric procedures worldwide. Its main weaknesses are weight regain and gastroesophageal reflux disease (GERD). Conversion to Roux-en-Y gastric bypass (RYGB) is considered the gold standard to manage GERD and related symptoms.

Methods

Retrospective evaluation from a prospective bariatric surgery database of all our institution’s patients converted from SG to RYGB due to GERD between January 2010 and December 2018. Clinical characteristics and workups before SG and before and after RYGB were analyzed.

Results

During the study period, 35 patients needed a conversion to RYGB, due to GERD or GERD-related symptoms. Mean age was 48.6 years, 85.7% were women, and mean BMI was 31.4 kg/m2. The interval between SG and RYGB was in a range 7 to 70 months (mean 33 months). All conversions were completed laparoscopically, associating a hiatoplasty in 45.7% of cases. A complete remission of symptoms was observed in 74% of patients, some improvement in 20%, and no relief in 6%. There were 3 cases of hiatal hernia persistence and 2 of recidivism. Only 1 patient presented pathological pHmetry, while moderate esophagitis was demonstrated in 2 patients.

Conclusions

Conversion to RYGB was effective in almost all patients. Pathological acid exposure and hiatal hernias seem to be the main findings prior to conversion, justifying an exhaustive examination and aggressive approach to the hiatus. Due to the insufficient correlation between symptoms and findings on morphological and functional tests, actively searching for signs of GERD is advisable.

Graphical abstract

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Metadata
Title
Outcomes of Conversion from Sleeve Gastrectomy to Roux-en-Y Gastric Bypass Due to GERD—a Retrospective Analysis of 35 Patients
Authors
Anna Curell
Marc Beisani
Amador García Ruiz de Gordejuela
Ramon Vilallonga
Mireia Verdaguer Tremolosa
Óscar González López
Enric Caubet Busquet
José Manuel Fort López-Barajas
Publication date
01-09-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 9/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05541-4

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