Clinical influence of conversion of laparoscopic sleeve gastrectomy to one anastomosis gastric bypass on gastroesophageal reflux disease

Apr 27, 2023Langenbeck's archives of surgery

Effects of Changing from Sleeve Gastrectomy to One-Anastomosis Gastric Bypass on Acid Reflux

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Abstract

Median Reflux Disease Questionnaire score significantly decreased from 30 pre-OAGB to 14 post-OAGB (p = 0.007).

All patients experienced sleeve resizing during the revision from LSG to OAGB.
The median follow-up time was 21.5 months, with a range of 3 to 65 months.
Significant reductions were observed in all three components of the GERD-health related quality of life score: symptoms, overall score, and subjective improvement.
Pre-OAGB GERD symptoms were reported by 62.5% of patients, decreasing to 31.3% post-OAGB (p = 0.012).
Overall GERD-related quality of life scores improved from 15 pre-OAGB to 7 post-OAGB (p = 0.04).

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PURPOSE: Assess the subjective impact of gastro-esophageal reflux disease (GERD) symptoms on patients undergoing revision from laparoscopic sleeve gastrectomy (LSG) to one-anastomosis gastric bypass (OAGB) using the Reflux Disease Questionnaire for GERD (RDQ) and the GERD-health related quality of life score (GERD-HRQL), prior to- and following conversion.

METHODS: Patients undergoing revision from LSG to OAGB were prospectively followed between May 2015 and December 2020. Data retrieved included demographics, anthropometrics, previous bariatric history, time interval between LSG and OAGB, weight loss, and co-morbidities. Pre- and post-OAGB RDQ and GERD-HRQL questionnaires were obtained. In the case of sleeve dilatation, sleeve resizing was performed.

RESULTS: During the study period, 37 patients underwent revision from LSG to OAGB. Mean ages at LSG and pre-OAGB were 38 ± 11.74 and 46 ± 12.75, respectively. Median follow-up time was 21.5 months (range 3-65). All patients underwent sleeve resizing. RDQ and GERD-HRQL scores were obtained at a median of 14 months (range 3-51) between pre- and post-OAGB. Median RDQ score pre-OAGB vs post-OAGB was significantly reduced (30 (range 12-72) vs 14 (range 12-60), p = 0.007). All 3 parts of the GERD- HRQL questionnaires were significantly reduced between pre-OAGB and post-OAGB: Symptoms (20; 62.5% vs 10; 31.3%, p = 0.012), overall score (15 (0-39) vs 7 (0-28), p = 0.04) and subjective improvement (10; 31% vs 20; 62.5%, p = 0.025).

CONCLUSION: Conversion of LSG to OAGB showed subjective improvement of GERD symptoms both in RDQ and in GERD-HRQL.

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Clinical influence of conversion of laparoscopic sleeve gastrectomy to one anastomosis gastric bypass on gastroesophageal reflux disease

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