Introduction The role of preoperative Gastroscopy in obesity surgery in detecting a lot of abnormalities
of Upper-GI such as GERD and BE`s has been already proved in our pervious study. The
Development of GERD and BE`s after bariatric surgery still controversy in the bariatric
surgery. The Aim of this study is to evaluate the development of GERD and BE`s in
patients underwent bariatric surgery including LGB and LSG
Material and Methods In our single center prospectively-established database of obese patients, who u
nderwent bariatric surgery from 01/2012 to 12/2019, we retrospectively compare the
preoperative endoscopic finding of patients with BE`s to these findings after 1-2
years and 3-5 years after the bariatric surgery. The regression of BE’s was defined
based on the endoscopic findings as a 1 cm down grade of Prague classification circumferential
(C) as well as maximum extent (M) or completeregression of BE’s, histologically as
a conversion of intestinal metaplasia to squamous epithelium or conversion of dysplastic
dysplasia to intestinal metaplasia
Results Among 914 bariatric patients, we found 119 patients (13%) with BE’s. A control gastroscopy
could be performed in 74 BE’s Patients (62.2%). 37 patients received a control gastroscopy
after 1-2 years and 47 patient after 3-5 years. Depending on our analysis, the surgical
procedure was the only significant factor for the development of GERD and BE’s after
bariatric surgery (P< 0.05). The progression of GERD after LGB was detected only in
one patient (4.2%, n=54) and in 10 patients (50%, n=10) after LSG in patients. Furthermore,
the progression of BE’s after LGB in 4 patient (7.4%, n=54) and in 6 patients (30%,
n=20) after LSG.
Conclusion Laparoscopic gastric bypass should be considered in obese patients with GERD or BE`s.
Therefore, detecting of GERD and BE`s prior to bariatric surgery may has an obvious
impact on decision making regarding the suitable surgical bariatric procedure.
Fig. 1
