Evaluation of gastro-oesophageal reflux disease after Sleeve Gastrectomy and the results of laparoscopic double loop gastric bypass in revisional surgery

Yardımcı E. , Coşkun H.

6. Ulusal ve 5. Akdeniz Morbid Obezite ve Metabolik Hastalıklar Kongresi, Antalya, Turkey, 17 - 20 October 2019, no.46, pp.24

  • Publication Type: Conference Paper / Full Text
  • City: Antalya
  • Country: Turkey
  • Page Numbers: pp.24


Introduction: Gastroesophageal reflux (GERD) might be occurred after Sleeve Gastrectomy (SG). In this study, we aimed to show the results of preoperative diagnostic tests and laparoscopic double loop gastric bypass (LDLGB) surgery for de novo GERD after SG. Material and Methods: From January 2018 to July 2019, 8 patients who underwent LDLGB for the conversion of SG because of GERD analyzed retrospectively. All patients who suffered from symptomatic and/or resistant reflux after SG underwent esophagogastroduodenoscopy (EGD), 24-hour esophageal pH meter and esophageal manometry. In the LDLGB procedure, sleeved stomach was transected above the incisura angularis via linear stapler to create the gastric pouch. The biliary limb was measured 100 cm distal to the Treitz ligament and gastrojejunostomy was performed using a linear stapler. Starting at this level, the alimentary limb was measured up to 100 cm and fixed by stitching it to the biliary limb. Side-to-side jejunojejunostomy was performed between alimentary and biliary limbs. Finally, the biliary loop and alimentary loop were separated using a linear stapler. Results: The mean preoperative BMI was 32±3.9 kg/m2 . At EGD, class A esophagitis and alkaline reflux(bile) gastritis was found in 75% and 87.5% of cases, respectively. The mean DeMeester score and mean lower esophageal sphincter pressure was 66.3 and 16.4±5.2 mmHg, respectively. The mean operation time was 164±24 minute. There was no complication recorded. The mean BMI was 25.7±1.4 kg/m2 in the follow-up period (mean 12.3±3.2 months). Reflux symptoms completely resolved in all patients. Conclusion: The evaluation of de novo GERD after SG is important and it should be diagnosed by appropriate tests. Conversion of SG to LDLGB is a reliable and feasible technique in the treatment of de novo GERD.