Fifteen Years after Sleeve Gastrectomy: Gastroscopies, Manometries, and 24-h pH-Metries in a Long-Term Follow-Up: A Multicenter Study

Obes Facts. 2022;15(5):666-673. doi: 10.1159/000526170. Epub 2022 Jul 26.

Abstract

Introduction: Sleeve gastrectomy (SG) is the most common bariatric operation with over 340,000 procedures per year. There are only few studies presenting follow-up results >10 years in the literature today. The aim of this study was the objective evaluation of long-term outcomes of at least 15 years after SG in non-converted patients.

Methods: This study (multicenter cross-sectional; university-hospital based) includes all non-converted patients with primary SG before December 2005 at participating bariatric centers. The following methods were used: gastroscopy, esophageal manometry, 24-h pH-metry, and Gastrointestinal Quality of Life Index (GIQLI).

Results: After removing converted patients, patients with bariatric procedures before SG, and deceased patients from the cohort, 20 of 53 participants have met the inclusion criteria. Of this group, 55% are suffering from symptomatic gastroesophageal reflux disease (GERD); 45% are without GERD. Esophagitis, hiatal hernias, Barrett's esophagus, and enlarged sleeves were found in 44%, 50%, 13%, and 69% of patients during gastroscopy. Mean lower esophageal sphincter pressure was normal at 20.2 ± 14.1 mm Hg during manometry. Reflux activity in 24 h, number of refluxes, and DeMeester score were increased at 12.9 ± 9.7%, 98.0 ± 80.8, and 55.3 ± 36.3 during 24-h pH-metry. Patients with GERD scored significantly lower in the GIQLI than patients without GERD: 107.6 ± 18.4 versus 127.6 ± 14.4 (p = 0.04).

Discussion/conclusion: Fifteen years after primary SG, objective testing has shown that GERD, esophagitis, and Barrett's esophagus are major issues for these patients. Surveillance endoscopies at 5-year intervals in all SG patients and 3-year intervals in patients with Barrett's esophagus are recommended.

Keywords: 24-h pH-metry; Barrett’s esophagus; Esophagitis; Gastroesophageal reflux disease; Gastroscopy; Manometry; Sleeve gastrectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Barrett Esophagus* / epidemiology
  • Barrett Esophagus* / surgery
  • Cross-Sectional Studies
  • Esophagitis* / epidemiology
  • Esophagitis* / surgery
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Gastroesophageal Reflux* / diagnosis
  • Gastroesophageal Reflux* / epidemiology
  • Gastroesophageal Reflux* / etiology
  • Gastroscopy
  • Humans
  • Hydrogen-Ion Concentration
  • Manometry
  • Obesity, Morbid* / surgery
  • Quality of Life

Grants and funding

No funding was required for this study.