A tailored approach for reflux management after sleeve gastrectomy: dispelling the notion that all need conversion to a gastric bypass.

Authors

Sakib M Adnan, Ayesha Siddiq, Mina Ibrahim, Leo Amodu, Mujjahid Abbas, Leena Khaitan

Published in

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. Jul 29, 2026. Epub Jul 29, 2026.

Abstract

Gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) can be challenging to manage, with conversion to Roux-en-Y gastric bypass (RYGB) as a common surgical therapy.
To evaluate an algorithmic approach for identifying alternatives to SG conversion to RYGB for GERD.
This is a single-center, retrospective review of all consecutive patients with persistent GERD after SG between January 2015 and July 2021.
After lifestyle optimization, patients underwent esophagram, manometry, Bravo pH studies, and esophagogastroduodenoscopy. Thereafter, the algorithm was followed to determine intervention. Prospective data were collected in an institutional database with long-term follow-up comparisons.
Sixty-four patients were managed (mean age 46 years; 92% female). Average time from index SG to surgical intervention was 4.04 years and mean follow-up was 5.8 years. Procedures included conversion to RYGB (n = 41), of which 26 had concomitant hiatal hernia repair (HHR), magnetic sphincter augmentation (n = 19), of which 12 had concomitant HHR, HHR alone (n = 3), and radiofrequency ablation (n = 1). Average body mass index was higher for those converted to RYGB (41.4 vs. 32.5). Average preoperative GERD-health-related quality of life (HRQL) improved from 38.9 to 9.3 at follow-up and high-dose/daily PPI use fell from 95% preoperative to 64% postoperative, with 28% off proton pump inhibitors at long-term follow-up. Outcomes did not differ by procedure type (P = .455 and .817, respectively). Four patients showed no GERD-HRQL improvement, with no association with procedure performed. (P = .455).
Utilizing a rigorous protocol, 36% of patients with GERD after SG were spared conversion to RYGB with excellent long-term outcomes, as demonstrated by improved GERD-HRQL scores and reduced PPI use.

PMID:
42760185
Bibliographic data and abstract were imported from PubMed on 19 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.