Incidence of Abnormalities of the Gastric Tube Following Sleeve Gastrectomy and Its Role on Esophagitis Progression

Obes Surg. 2023 Jan;33(1):263-267. doi: 10.1007/s11695-022-06375-4. Epub 2022 Dec 3.


Purpose: The purpose of this study is to determine the incidence of gastric tube abnormalities after SG and its relationship with esophagitis progression.

Methods: Retrospective study which included 459 patients in the postoperative period of SG who underwent an esophagogastroduodenoscopy in both pre- and postoperative periods. The main studied variables were presence of gastric tube abnormalities (dilation, neofundus, twist, and hiatal hernia) and esophagitis progression.

Results: Among the 459 patients who underwent SG, 393 (85.6%) were women, and 66 (14.4%) men, with mean age of 40.4 years. Mean preoperative BMI was 39.70 kg/m2. In total, 20.3% of the sample presented progression of esophagitis after surgery. Among the whole sample, 130 (28.3%) presented with an abnormality of the remnant gastric tube. The most common alteration was gastric dilation, which occurred in 16.1% of the patients, followed by gastric twist (10.7%), neofundus (7.4%), and hiatal hernia (0.2%). Patients who presented with any abnormality of the gastric tube were significantly prone to presenting esophagitis progression (p = 0.013). When analyzing each morphological abnormality isolated, there was no statistically significant correlation.

Conclusion: Abnormalities of the gastric tube are not uncommon after SG and seems to contribute partially to the relevant rates of GERD and esophagitis after this surgery.

Keywords: Esophagitis; Gastric fundus; Gastric volvulus; Gastroesophageal reflux disease; Hiatal hernia; Sleeve gastrectomy; Stomach dilation.

MeSH terms

  • Adult
  • Esophagitis* / epidemiology
  • Esophagitis* / etiology
  • Esophagitis* / surgery
  • Female
  • Gastrectomy / adverse effects
  • Gastroesophageal Reflux* / etiology
  • Hernia, Hiatal* / surgery
  • Humans
  • Incidence
  • Laparoscopy* / adverse effects
  • Male
  • Obesity, Morbid* / surgery
  • Retrospective Studies