Erosive Esophagitis after Bariatric Surgery: Banded Vertical Gastrectomy versus Banded Roux-en-Y Gastric Bypass

Obesity is associated with gastroesophageal reflux disease. Roux-en-Y gastric bypass is the most performed bariatric procedure in the world, whereas sleeve gastrectomy is an emerging procedure. Both can be combined with the use of a SilasticA (R) ring. The aim of this study was to compare the evolution of erosive esophagitis (EE) in patients who underwent SilasticA (R) ring gastric bypass (SRGB) and SilasticA (R) ring sleeve gastrectomy (SRSG) after a 1-year postoperative period. We carried out a non-randomized, prospective, controlled clinical study. Sixty-five patients were enrolled based on the following inclusion criteria: female gender, age 20-60 years old, BMI 40-45 and written informed consent. The exclusion criteria were secondary obesity, alcohol or drug use, severe psychiatric disorder, binge-eating of sweets, and previous stomach or bowel surgery. The patients were divided into two groups-33 (51%) underwent SRSG and 32 (49%) patients underwent SRGB. All patients underwent an esophago-gastro-duodenoscopy during the preoperative period and at 12-14 months after the surgery. Preoperatively, 15 patients (23.8%) were found to have EE, six (19.4%) in the SRSG group and nine patients (28.1%) in the SRGB group (p = 0.7795). Postoperatively, there was an increase in the number of patients with EE in the SRSG group to 14 (45.2%) and a decrease in the SRGB group to two (6.3%), giving a total of 16 patients with EE (25.4%; p = 0.0007). After 1 year of follow-up, we observed a worsening evolution of EE in the SRSG group, but improvement in the SRGB group.