Risks of Barrett's esophagus after laparoscopic sleeve gastrectomy
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16143Keywords:
Barrett's esophagus, gastroesophageal reflux disease, laparoscopic sleeve gastrectomy, laparoscopy, endoscopyAbstract
The aim of the work: to investigate and determine the prevalence of Barrett’s esophagus 5 years after laparoscopic sleeve gastrectomy (LSG).
Materials and Methods. A retrospective cohort study was conducted at a high-volume bariatric center – Kyiv Regional Clinical Hospital. Patients who had undergone LSG 5 years prior to the study initiation and completed postoperative esophagogastroduodenoscopy were included. Endoscopic Barrett’s esophagus was defined as the presence of columnar epithelium extending ≥1 cm above the gastroesophageal junction, with histological confirmation of columnar metaplasia with or without intestinal metaplasia. Symptomatic gastroesophageal reflux disease (GERD) was defined clinically by the presence of typical symptoms (heartburn and/or regurgitation) documented by a physician.
Results. A total of 114 patients who completed 5-year follow-up after LSG were included. The mean age was (44.09±10.95) years, and 61 % were female. Five years after surgery, the mean body mass index decreased to (27.40±5.75) kg/m², and the mean total weight loss (% TWL) was (30.02±12.24) %. Barrett’s esophagus was identified in 3 (2.6 %) patients; all cases were short-segment Barrett’s esophagus without intestinal metaplasia. In one case, the preoperative endoscopy was normal.
Conclusions. The findings are consistent with existing literature demonstrating an increased incidence of GERD and esophagitis after LSG, while indicating a relatively low but clinically relevant risk of Barrett’s esophagus development. Long-term follow-up with routine endoscopic surveillance remains essential for early detection and management of reflux-related complications in patients after LSG.
References
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017; 27:2279-89. DOI: 10.1007/s11695-017-2666-x. DOI: https://doi.org/10.1007/s11695-017-2666-x
Berger ER, Huffman KM, Fraker T, et al. Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the metabolic and bariatric surgery accreditation and quality improvement program. Ann Surg. 2018; 267:122-31. DOI: 10.1097/SLA.0000000000002079. DOI: https://doi.org/10.1097/SLA.0000000000002079
Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA. 2018; 319:241-54. DOI: 10.1001/jama.2017.20313. DOI: https://doi.org/10.1001/jama.2017.20313
Yeung KTD, Penney N, Ashrafian L, et al. Does sleeve gastrectomy expose the distal esophagus to severe reflux? A systematic review and meta-analysis. Ann Surg. 2020; 271:257-65. DOI: 10.1097/SLA.0000000000003275. DOI: https://doi.org/10.1097/SLA.0000000000003275
Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017; 13:568-74. DOI: 10.1016/j.soard.2016.11.029. Epub. 2016 Dec. 9. DOI: https://doi.org/10.1016/j.soard.2016.11.029
Nadaleto BF, Herbella FA, Patti MG. Gastroesophageal reflux disease in the obese: pathophysiology and treatment. Surgery. 2016; 159:475-86. DOI: 10.1016/j.surg.2015.04.034. Epub. 2015 Jun. 6. DOI: https://doi.org/10.1016/j.surg.2015.04.034
Chang P, Friedenberg F. Obesity and GERD. Gastroenterol Clin North Am. 2014; 43:161-73. DOI: 10.1016/j.gtc.2013.11.009. DOI: https://doi.org/10.1016/j.gtc.2013.11.009
Leggett CL, Nelsen EM, Tian J, et al. Metabolic syndrome as a risk factor for Barrett esophagus: a population-based case-control study. Mayo Clin Proc. 2013; 88:157-65. DOI: 10.1016/j.mayocp.2012.09.017. DOI: https://doi.org/10.1016/j.mayocp.2012.09.017
Khan A, Kim A, Sanossian C, Francois F. Impact of obesity treatment on gastroesophageal reflux disease. World J Gastroenterol. 2016; 22:1627-38. DOI: https://doi.org/10.3748/wjg.v22.i4.1627
Chiu S, Birch DW, Shi X, et al. Effect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis. 2011; 7:510-5. DOI: 10.1016/j.soard.2010.09.011. Epub. 2010 Sep. 21. DOI: https://doi.org/10.1016/j.soard.2010.09.011
Garay M, Balagué C, Rodríguez-Otero C, et al. Influence of antrum size on gastric emptying and weight loss outcomes after laparoscopic sleeve gastrectomy (preliminary analysis of a randomized trial). Surg Endosc. 2018; 32:2739-45. DOI: 10.1007/s00464-017-5972-4. DOI: https://doi.org/10.1007/s00464-017-5972-4
Neagoe R, Muresan M, Timofte D, et al. Long-term outcomes of laparoscopic sleeve gastrectomy – a single-center prospective observational study. Videosurgery Miniinv. 2019; 14:242-8. DOI: https://doi.org/10.5114/wiitm.2019.84194
Gemici E, Kones O, Seyit H, et al. Outcomes of laparoscopic sleeve gastrectomy by means of esophageal manometry and pH-metry, before and after surgery. Videosurgery Miniinv. 2020; 15:129-35. DOI: 10.5114/wiitm.2019.83198. Epub. 2019 Feb. 25. DOI: https://doi.org/10.5114/wiitm.2019.83198
El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-esophageal reflux disease: a systematic review. Gut. 2014; 63:871-80. DOI: 10.1136/gutjnl-2012-304269. Epub. 2013 Jul. 13. DOI: https://doi.org/10.1136/gutjnl-2012-304269
Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017; 27:3092-101. DOI: 10.1007/s11695-017-2748-9. DOI: https://doi.org/10.1007/s11695-017-2748-9
Ryan AM, Healy LA, Power DG, et al. Barrett esophagus: prevalence of central adiposity, metabolic syndrome, and a proinflammatory state. Ann Surg. 2008; 247:909-15. DOI: 10.1097/SLA.0b013e3181612cac. DOI: https://doi.org/10.1097/SLA.0b013e3181612cac
Mion F, Tolone S, Garros A, et al. High-resolution impedance manometry after sleeve gastrectomy: increased intragastric pressure and reflux are frequent events. Obes Surg. 2016; 26:2449-56. DOI: 10.1007/s11695-016-2127-y. DOI: https://doi.org/10.1007/s11695-016-2127-y
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