gms | German Medical Science

Background: Gastric acid production, hiatus hernia and increased intra abdominal pressure in the obese patient are supporting GERD. Gastric sleeve resection for weight reduction with the resection of the angle of HIS, a great part of the acid producing B-cells and weight loss associated with a decrease in intra abdominal pressure as a result of the operation will potentially ameliorate GERD. However gastric sleeve is considered a contra indication in patients with GERD and gastric bypass is proposed instead.

Materials and methods: The incidence and course of GERD was investigated in 80 consecutive patients undergoing sleeve resection. Follow up was performed 3,6,12 months post op and yearly thereafter by clinical signs of GERD i.e. medical history, requirement of antacids and gastroscopy.

17 patients were males and 63 females. The BMI was 49.5kg /m². 17 patients (21%) required antacids preoperatively but without signs of reflux esophagitis.

Statistics: The student t-test was used for quantitative differences and Fisher´s exact test for qualitative differences.

Results: A total of 9 patients (11%) developed De Novo GERD with treatment required. Out of 17 preoperatively symptomatic patients 13 (76%) could discontinue medication, 4 (24%) continued to require therapy (p<0.0001). Weight reduction was 14 BMI points one year after surgery (p<0.0001).

No patient required change to gastric bypass construction.

Conclusion: The data suggest that GERD following gastric sleeve can occur the course however of pre existing GERD is mild in the majority of patients or can develop into cure of GERD most likely due to the effective weight reduction and resection of acid producing cells. However GERD is also reported in patients