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Inicio Cirugía Española (English Edition) Gastroesophageal reflux management after vertical sleeve gastrectomy
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Vol. 101. Issue S4.
Pages S52-S57 (October 2023)
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Vol. 101. Issue S4.
Pages S52-S57 (October 2023)
Special article
Gastroesophageal reflux management after vertical sleeve gastrectomy
Manejo del reflujo gastroesofágico después de la gastrectomía vertical
Ester Martínez Negroa,
Corresponding author
emartineznegro@gmail.com

Corresponding author.
, Sagrario Martínez Cortijob
a Hospital Nuestra Señora del Prado Talavera, Talavera de la Reina, Toledo, Spain
b Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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Table 1. Studies that demonstrate the appearance of esophagitis and BE after LSG.
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Vol. 101. Issue S4
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Abstract

VSG is the most used surgical procedure in the world. Among the main complications linked to this procedure is GERD. It is apparent that endoscopic control protocols should be undertaken in all patients recovering from a VSG procedure. This is particularly key when taking into account the large number of patients suffering from GERD that show no symptoms, a situation that in many cases leads to severe esophagitis or even adenocarcinoma. Once the pertinent diagnostic tests have been carried out, the specialist should seek a conservative medical treatment including PPI. In the event that this treatment should fail, the next step to be considered should be a surgical procedure. In this case, the ideal procedure would be a reconversion to gastric bypass due to its low-risk and its results. There are other alternatives such as the Stretta, Linx or ARMS procedures; however, further research is necessary to prove their reliability.

Keywords:
Vertical sleeve gastrectomy
GERD
Obesity
Bariatric surgery
Complications
Resumen

La gastrectomía vertical es la técnica de cirugía bariátrica más realizada en el mundo. Una de sus principales complicaciones es el reflujo gastroesofágico. A la vista de estos resultados queda claro que deben realizarse de forma protocolizada controles endoscópicos en todos los pacientes intervenidos de gastrectomía vertical sobre todo si tenemos en cuenta la gran cantidad de pacientes asintomáticos que presentan dicha patología y que en muchos casos pueden desencadenar esofagitis severas e incluso adenocarcinomas. Una vez realizadas las pruebas diagnósticas adecuadas, debe iniciarse tratamiento médico conservador con IBP y hacer un seguimiento estricto de estos pacientes. En caso de que fracase el tratamiento conservador, debe plantearse un tratamiento quirúrgico. La reconversión a Bypass Gástrico es la cirugía de elección por su seguridad y resultados. Existen otras técnicas endoscópicas como el Stretta o Linx que pueden plantearse como alternativas, aunque todavía hacen falta más estudios que demuestren su efectividad.

Palabras clave:
Gastrectomía vertical
ERGE
Obesidad
Cirugía bariátrica
Complicaciones

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