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Concomitant Obesity and GERD: Is Laparoscopic Sleeve Gastrectomy Still Considered the Best Option? A Clinical and Endoscopic Evaluation

World Journal of Laparoscopic Surgery • 2021
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Publication Information
Authors Ehab M Oraby1, Ola A Harb2, Mokhtar A Bahbah3
Keywords Body mass index, Gastro-esophageal reflux disease, Obesity, Sleeve gastrectomy.
Journal World Journal of Laparoscopic Surgery
Publisher Jaypee Brothers Medical Publishers (P) LTD.
Volume Not Available
Issue Not Available
Pages Not Available
publication.type International
Paper Link Not Available
Supplementary Materials Not Available
Abstract
Background: Obesity is a real worldwide problem. About one billion people are suffering from obesity all over the world. Two-thirds of the communities are adults, then the remaining one-third are children and adolescents. Obese patients especially those with central obesity are showing an incidence of 20–50% for preexisting gastro-esophageal reflux disease (GERD).
Objectives: This paper is trying to define the relationship between these items in obese patients in our community through clinical and endoscopic evaluation. Patients and methods: This prospective study involved 61 patients who were scheduled for bariatric procedures. All patients were invited to answer a GERD questionnaire and to do upper GI endoscopy twice: once preoperative and second time 1 year postoperatively. Patients were divided into three groups regarding preexisting GERD and operative procedure. Results: Group A patients showed significant worsening of GERD scores, endoscopic esophagitis grade, and PPI dependency. Group B patients showed significant improvement in GERD scores without improvement in esophagitis grade. Group C patients showed multifactorial significant improvement. Conclusion: Laparoscopic sleeve gastrectomy (LSG) operation seems to be truly a refluxogenic procedure, while Roux-En-Y gastric bypass (RYGB) should be considered as better alternatives to avoid postoperative worsening of GERD and degree of esophagitis. These results need
confirmation by studies with a bigger number of patients.