Background

For sleeve gastrectomy (SG) patients with preoperative GERD diagnoses, the literature surrounding worsening postoperative GERD is discordant. Moreover, few studies use functional testing to determine GERD status, relying on symptomatic evaluations instead. This study aimed to evaluate the effects of SG on patients with GERD diagnosed through 24-hour esophageal pH-testing.

Methods

This was a retrospective, single-center case series. SG patients with preoperative pH testing were identified and compared based on DeMeester scoring. Preoperative demographics, endoscopy results, need for conversion surgery, and changes in gastrointestinal quality of life (GQLI) scores were compared. 2- sample independent t-tests assuming unequal variances were used for statistical analysis.

Results

20 SG patients had preoperative pH testing. 9 patients had abnormal DeMeester scores (cut-off 14.7) and were GERD positive; median DeMeester score 26.7 (22.1-31.15) and median BMI of 41.3 (38.35-47.09) kg/m2. 11 patients had negative DeMeester scores and were GERD negative, with a median DeMeester score of 9.0 (4.5-13.1) and median BMI of 43.9 (36.7-49.6) kg/m2. The two groups had similar preoperative endoscopic findings and use of GERD medications. Concurrent hiatal hernia repair was performed in 33.3% of patients (22% vs. 36% for GERD positive vs negative patients, p=0.512). Only one patient in positive GERD cohort required conversion to gastric bypass (11%). No significant postoperative differences were noted in GQLI, heartburn, or regurgitation symptoms.

Conclusions

Selected patients with GERD diagnosis undergoing SG do not experience profound worsening of their GERD postoperatively. SG may be a viable surgical option for selected patients with GERD at baseline.