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