The prevalence of Barrett's esophagus after laparoscopic sleeve gastrectomy: a retrospective study in the United States.

Abstract

Background/Aims With the increase in the number of patients undergoing laparoscopic sleeve gastrectomy (LSG), gastroesophageal reflux disease (GERD) has emerged as a concerning side effect. Chronic GERD is a well-established risk factor for the development of Barrett's esophagus (BE). This study aimed to determine the prevalence of BE in patients who underwent LSG. Methods We conducted a retrospective observational study of patients who underwent LSG at four hospitals over ten years. Patients included were those who had an esophagogastroduodenoscopy (EGD) with biopsy prior to and at least six months after LSG. EGD and pathology reports were reviewed to confirm the diagnosis of BE and/or esophageal adenocarcinoma. Results Of the 422 LSG patients who underwent EGD after surgery, five (1.2%) were found to have de novo BE, and none of the patients had esophageal adenocarcinoma. There was a significant increase in post- compared to preoperative acid reflux symptoms (20.1% vs. 59.5%, p<0.001), mild esophagitis (9.7% vs. 18.5%, p<0.001), and moderate-to-severe esophagitis (1.4% vs. 9.5%, p<0.001). Conclusions The prevalence of de novo BE among patients with LSG was lower than expected (1.2%) given the significant increase in acid reflux symptoms and esophagitis observed after surgery.