Incidence of Esophageal Reflux after Laparoscopic Sleeve Gastrectomy for Morbid Obesity

Background: Obesity is considered as an epidemic globally, which associated with gastroesophageal reflux disease (GERD). Bariatrics surgery tends to reduce GERD manifestations. However, some reports noticed development of GERD after bariatric surgery; the problem which not addressed well in our community. Aim of the work: To estimate incidence of postoperative GERD after laparoscopic sleeve gastrectomy (SG) in patients with no history of GERD symptoms prior to surgery. Patients and Methods: Fifty morbidly obese patients who were scheduled for laparoscopic SG with no history of preoperative symptoms suggesting GERD and normal upper gastrointestinal endoscopy were included. All were assessed clinically and radiologically and followed-up for clinical or endoscopic GERD manifestations. Results: Females were predominant (76.0%). Weight, body mass index and waist/hip ratio were significantly reduced after SG. Postoperative complications were leak (2.0%), wound infection (2.0%), bleeding (2.0%), stricture (4.0%) with overall rate of 8.0%. Incidence of GERD was 22.0% (11 patients; 4 grade A, 5 grade B and 2 grade C). There was significant increase of Waist/hip ratio (both pre-and postoperatively) in patients who developed GERD when compared to those who did not develop GERD. In addition, there was significant increase of sleep related problems and stricture in patients who developed GERD when compared to those did not develop GERD (63.6%, 18.2% vs 17.9%, 0.0% respectively). Conclusion: the incidence of GERD after SG was 22.0%. It was of mild or moderate nature, which denotes safety of SG. The procedure is also associated with marked weight reduction.