Nezar A. Almahfooz
Background: Gastroesophageal reflux Disease(GERD) is frequently encountered in obese patients. Laparoscopic sleeve gastrectomy (LSG) is a valid operation to overcome obesity, unfortunately associated with significant percent of GERD and De novo GERD. Objectives: The aim of this descriptive study isto assess the incidence of GERD in obese patients in relation to Laparoscopic Sleeve gastrectomy. Aid to identify the suitable antireflux procedure. Methods: This is a descriptive study, tracing (2210) obese patients from 2008-2018 in high volume single government and 4 private hospitals scheduled for LSG in relation to GERD. Records and investigationsfor GERD symptoms analyzed. GERD patients preoperatively are subjected to 3 varieties of antireflux procedures combined with LSG. De novoGERD patients are subjected to RYGB usually and different other options discussed from literature review. Results: The number of obese patientssubjected to LSG was(2210), and followed up 3monthsto 10 years, the mean period is 46.5 months. GERD patients were 520 (23.5%), De novo GERD 118(5.33%). Cruroplasty with LSG was the standard procedure for GERD and/or hiatal hernia, 4 (7.6%) casessubjected toNissen and Rossetti fundoplication with LSG. RYGB is offered for 9 (20%) patients with De novo GERD with excellent outcome. Conclusion: Gastroesophageal reflux disease GERD is inevitable in Obese patients and encountered often post sleeve gastrectomy. The best procedure to avoid GERD is RYGB. If LSG is mandatory it’s preferable to be done for patients without reflux symptoms, and if symptoms present combined LSG with Nissen or Rossetti fundoplication is preferable.
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