Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;39(1):194-203.
doi: 10.1007/s00464-024-11359-9. Epub 2024 Nov 4.

Effect of sleeve gastrectomy on distal esophagus at 5 and 10 years

T Barreteau  1 , S Frey  1   2 , M de Montrichard  1 , A Dreant  3 , T Matysiak Budnik  3 , D Jacobi  2   4 , B Perrot  5 , C Blanchard  6   7
Affiliations

Effect of sleeve gastrectomy on distal esophagus at 5 and 10 years

T Barreteau et al. Surg Endosc. 2025 Jan.

Abstract

Background: Sleeve gastrectomy (SG) is a primary surgical intervention for obesity management. However, several longitudinal studies have documented the emergence of long-term esophageal consequences, notably gastroesophageal reflux disease (GERD) and its associated complications. This study aimed to assess the occurrence of esophageal complications, including esophagitis and Barret's esophagus (BE), 5 and 10 years after SG, in one medical center.

Methods: Two cohorts of consecutive patients who underwent SG were studied: patients who underwent a systematic upper gastro-intestinal endoscopy (UGIE) at five years or conversion to RYGB < 5 years (cohort n°1, n = 219), and patients who underwent UGIE at 10 years or converted to RYGB > 5 years (cohort n°2, n = 72). Patients with missing UGIE before or after SG were excluded.

Results: In the cohort n°1, 62.7% of the patients had clinical GERD at the 5-years follow-up (vs. 21.8 before SG, p < 0.0001), 27.4% had esophagitis (vs. 14.2% before SG, p = 0.0006), and 8.3% had BE (vs. 1.8% before SG, p = 0.002) with metaplasia in 1.8%. De novo esophagitis and BE accounted for 19.6% and 7.8%, respectively. In the cohort n°2, at 10 years, 61.5% had clinical GERD (vs.12.5 before SG, p < 0.0001), 23.6% had esophagitis (vs. 9.7% before SG, p = 0.025) including 20.8% de novo, and 8.3% had de novo BE, with metaplasia in 5.6%. De novo esophagitis accounted for 20.8%. One patient developed esophageal adenocarcinoma 10 years after SG. Pre-operative esophagitis was significantly associated with BE on UGIE at 5 or 10 years, while active smoking and preoperative esophagitis were risk factors for esophagitis.

Conclusion: This study highlights a significant increase in esophageal complications 5 and 10 years after SG. Pre-operative esophagitis should be considered when choosing a surgical technique for obesity management.

Keywords: Bariatric surgery; Barret’s esophagus; Esophageal adenocarcinoma; Esophagitis; Gastroesophageal reflux disease; Sleeve gastrectomy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Disclosures: Drs Thomas Barreteau, Samuel Frey, Marie de Montrichard, Alexandre Dreant, Bastien Perrot, and Pr Tamara Matysiak-Budnik have no conflicts of interest or financial ties to disclose. Pr David Jacobi has an equity interest in participation on a Data Safety Monitoring Board, support for attending meetings and/or travel, payment for expert testimony, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, consulting fees, and grants or contracts from any entity with Eli Lilly, Amgen, Novo Nordisk, and Pfizer. Pr David Jacobi has a role of member of GCC-CSO in France. Pr Claire Blanchard has an equity interest in payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events with Gore, Medtronic, Johnson & Johnson, and Novonordisk.

References

    1. OMS - Obésité et surpoids. https://www.who.int/fr/news-room/fact-sheets/detail/obesity-and-overweight
    1. Felsenreich DM, Bichler C, Langer FB, Gachabayov M, Prager G (2020) Sleeve gastrectomy: surgical technique, outcomes, and complications. Surg Technol Int 28(36):63–69 (PMID: 32359172)
    1. Guzman-Pruneda FA, Brethauer SA (2021) Gastroesophageal reflux after sleeve gastrectomy. J Gastrointest Surg 25:542–550. https://doi.org/10.1007/s11605-020-04786-1 . (PMID: 32935271) - DOI - PubMed
    1. Genco A, Soricelli E, Casella G et al (2017) Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis 13:568–574 - DOI - PubMed
    1. Himpens J, Dobbeleir J, Peeters G (2010) Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 252(2):319–324 - DOI - PubMed

LinkOut - more resources