Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
Outcomes of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass for the treatment of gastroesophageal reflux disease.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Cymbal Michael, Prado Renan, Sierra Leandro, Chatterjee Arjun, Firkins Stephen A, Patel Roma, Khurana Akash, Yang Qijun, McMichael John, Flora Bailey, Staneff Erika, Simons-Linares Roberto
Аннотация
BACKGROUND: Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure in the United States, but it is associated with an increased risk of de novo or worsened gastroesophageal reflux disease (GERD). Conversion to Roux-en-Y gastric bypass (RYGB) is considered the gold standard for treating refractory GERD after SG, though objective outcomes remain under-reported.
OBJECTIVES: To evaluate the efficacy of conversion from SG to RYGB for medically refractory GERD using objective measures of improvement. Secondary objectives included assessing whether weight loss, additional anatomic repairs, or application of updated American College of Gastroenterology (ACG) GERD diagnostic criteria impacted outcomes.
SETTING: Academic tertiary care center (Cleveland Clinic Foundation, Cleveland, Ohio, United States).
METHODS: A retrospective cohort study was conducted on patients who underwent SG followed by RYGB for refractory GERD from July 2004 to August 2024. GERD improvement was defined as decreased use of proton pump inhibitors (PPIs), endoscopic, or pH testing improvement. Logistic regression and chi-square analyses were used to assess predictors of improvement.
RESULTS: Of 117 patients, 53 (45.3%) showed objective GERD improvement post-RYGB. Most improved via reduction in PPI omeprazole equivalence (88.7%), of which 35.8% discontinued PPIs completely. Neither total body weight loss (P = .257) nor concurrent anatomical repairs (P = .615) correlated with GERD improvement. Meeting new ACG GERD diagnostic criteria was significantly associated with improvement (63.6% vs 33.3%, P = .03).
CONCLUSION: Conversion to RYGB results in objective GERD improvement in nearly half of patients undergoing conversion, independent of weight loss or anatomical repairs. ACG diagnostic criteria may help predict which patients benefit most. Prospective studies are needed to validate findings and refine surgical decision-making.
OBJECTIVES: To evaluate the efficacy of conversion from SG to RYGB for medically refractory GERD using objective measures of improvement. Secondary objectives included assessing whether weight loss, additional anatomic repairs, or application of updated American College of Gastroenterology (ACG) GERD diagnostic criteria impacted outcomes.
SETTING: Academic tertiary care center (Cleveland Clinic Foundation, Cleveland, Ohio, United States).
METHODS: A retrospective cohort study was conducted on patients who underwent SG followed by RYGB for refractory GERD from July 2004 to August 2024. GERD improvement was defined as decreased use of proton pump inhibitors (PPIs), endoscopic, or pH testing improvement. Logistic regression and chi-square analyses were used to assess predictors of improvement.
RESULTS: Of 117 patients, 53 (45.3%) showed objective GERD improvement post-RYGB. Most improved via reduction in PPI omeprazole equivalence (88.7%), of which 35.8% discontinued PPIs completely. Neither total body weight loss (P = .257) nor concurrent anatomical repairs (P = .615) correlated with GERD improvement. Meeting new ACG GERD diagnostic criteria was significantly associated with improvement (63.6% vs 33.3%, P = .03).
CONCLUSION: Conversion to RYGB results in objective GERD improvement in nearly half of patients undergoing conversion, independent of weight loss or anatomical repairs. ACG diagnostic criteria may help predict which patients benefit most. Prospective studies are needed to validate findings and refine surgical decision-making.