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J Obes Eat Disord, 2017
ISSN: 2471-8203
August 23-24, 2017 | Toronto, Canada
allied
academies
INTERNATIONAL OBESITY, BARIATRIC AND
METABOLIC SURGERY SUMMIT AND EXPO
Objectives:
Laparoscopic sleeve gastrectomy (LSG) has become a popular
one-stage bariatric procedure with a proven efficacy on weight loss.
However, the relationship between LSG and gastroesophageal reflux disease
(GERD) remains a subject of debate. The objective is to determine the long-
term effect of LSG on weight loss and reflux disease.
Methods:
A retrospective analysis of 100 consecutive patients who
underwent a LSG between January 2005 and March 2009 was performed.
The effect of LSG on weight evolution and the relationship between pre-
operative and post-operative GERD symptoms and PPI dependency was
analysed.
Results:
A mean follow-up of 8.48 years (range 6.1-10.3) was achieved. We
observed a long-term % excess weight loss (%EWL) of 60%. A significant
increase in reflux symptoms and use of PPIs was seen. Seventeen
percent suffered from reflux disease preoperatively, versus 50% at the
end of the postoperative follow-up (RR=2.5882, 95% CI [1.6161-4.1452],
p-value=0.0001). The chance of developing
de novo
reflux after LSG was
47.8% (32/67). Reflux disease was present in 7 of the 26 patients who
underwent a secondary Roux-en-Y gastric bypass (RYGB). In 4 of these 7
patients, reflux disease disappeared completely after the secondary RYGB
(57.1%).
Conclusions:
A satisfactory long-term effect on weight loss was achieved.
However, a significant increase in GERD and PPI dependency after LSG was
noted. New onset GERD was seen in more than 40% of the study population.
Conversion to RYGB is a good option in patients with refractory reflux
disease after LSG.
Speaker Biography
Bart Smet has completed his graduation as General Surgeon with special interest
in Bariatric Surgery in 1998 from Leuven University. Currently, he is working in a
regional hospital in Roeselare, Belgium as Consultant. The department is performing
about 450 bariatric procedures, covering the full spectrum from bypass over sleeve
to malabsorptive procedures and redo surgery. He has presented bariatric topics
on several national and international meetings and was faculty member of multiple
bariatric masterclasses and expert meetings. Clinical immersion, live surgery by tele
mentoring and proctoring abroad are regularly organized within his department.
e:
david.j71@outlook.comModerating the enthusiasm of sleeve gastrectomy: Up to fifty percent of reflux symptoms after ten
years in a consecutive series of one hundred laparoscopic sleeve gastrectomies
Bart Smet, Yannick Mandeville, Ruth Van Looveren, Peter Jan Vancoillie, Xander Verbeke, Katrien Vandendriessche, Patrick Vuylsteke
and
Paul Pattyn
AZ-Delta ziekenhuis, Belgium
Bart Smet et al., J Obes Eat Disord, 3:2
DOI: 10.21767/2471-8203-C1-002