Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery — an International Experts’ Survey

PGEMU collaborators

doi:10.1007/s11695-023-06481-x

Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery — an International Experts’ Survey

PGEMU collaborators

Bar-Ilan University - Azrieli Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Objective: This study aimed to survey international experts in metabolic and bariatric surgery (MBS) to improve and consolidate perioperative interventions to prevent gastroesophageal reflux disease (GERD) and marginal ulcers (MU) after MBS. Background: Very important long-term complications after MBS include GERD, Barrett’s esophagus, and MU. Prevention might be fundamental to reduce the incidence, severe complications, and the increasing number of revisional bariatric surgeries. Methods: An international scientific team designed an online confidential questionnaire with 45 multiple-choice questions. The survey was sent to 110 invited experts and 96 of them (from 41 different countries) participated from 21 July 2022 to 4 September 2022. Results: Most experts (≥ 90%) prescribe postoperative acid suppression agents after MBS. Life-long proton pump inhibitors prophylaxis in smokers with avoidance of non-steroidal anti-inflammatory drugs are recommended by most of the experts (66%, 73%) after any type of gastric bypass. Two-thirds of experts (69%) perform Helicobacter pylori eradication prior to MBS. Two-thirds of experts (68%) routinely perform EGD and biopsy before MBS. Follow-up esophagogastroduodenoscopy (EGD) and timing threshold for revisional and conversional MBS were variable among experts. Conclusion: This expert survey underlines important perioperative interventions that reached a two-thirds consensus among MBS international experts. Variability in follow-up EGD, approach to complication management, and thresholds for revisional and conversional MBS emphasize the need for further researches and consensus guidelines. Graphical Abstract: [Figure not available: see fulltext.]

Original language	English
Pages (from-to)	1449-1462
Number of pages	14
Journal	Obesity Surgery
Volume	33
Issue number	5
DOIs	https://doi.org/10.1007/s11695-023-06481-x
State	Published - May 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Funding

BKA reports consultant roles with Endogenex, Endo-TAGSS, Metamodix, and BFKW; consultant and grant/research support from USGI, Apollo Endosurgery, Spatz Medical, Aspire Bariatrics, Boston Scientific; speaker roles with Olympus, Johnson and Johnson; speaker and grant/research support from Medtronic, Endogastric solutions; grant support from ERBE Medical. PGEMU (Prevention on GERD and Marginal Ulcers) collaborators: Collaborative authors in alphabetical orders: Edo Aarts Imran Abbas Luigi Angrisani Luciano Antozzi Tanseer Asghar Ahmad Bashir Estuardo Behrens Mohit Bhandari Aperna Bhasker Helmuth Billy Miguel-A. Carbajo Jean Marc Chevallier Ricardo Cohen Jerome Dargent Maurizio De Luca Eduardo de Moura Bruno Dillemans Nicola Di Lorenzo Mohamad Hayssam El Fawal Daniel Moritz Felsenreich Sigal Fishman Michael Gagner Manoel Galvao Khaled Gawdat Tikfu GEE Bijan Ghavami Ashraf Haddad Andres Hanssen Miguel F. Herrera Kelvin Higa Jacques M Himpens Kazunori Kasama Radwan Kassir Amir Khan Nesreen Khidir Mousa Khoursheed Haris Khwaja Lillian Kow Matt Kroh Kuldeepak Singh Kular Panagiotis Lainas Muffazal Lakdawala Laurant Layani Ken Loi Kamal Mahawar Tarek Mahdy Tom Mala Karl Miller Mario Musella Alexander Neymark Abdelrahman Nimeri David Nocca Patrick Noel Taryel Omarov Mariano Palermo Chetan Parmar Abdolreza Pazouki Luis Poggi Tigran Poghosyan Liza Pompa Jaime Ponce Dimitri Pournaras Arun Prasad Ayaad Alqahtani Almino Ramos Masoud Rezvani Karl Rheinwalt Rui Ribeiro Adriana Rotundo Elena Ruiz-Ucar Bassem Safadi Nasser Sakran Paulina Salminen Oliver Schroeder Yosuke Seki Asim Shabbir Shahab Shahabi Shahmiri Scott Shikora Jürgen Stein Erik Stenberg Eren Taskin Antonio Torres Ramon Villalonga Rudolf Weiner Sylvia Weiner Wah Yang Joerg Zehetner Natan Zundel

Funders	Funder number
Apollo Endosurgery
BFKW
ERBE Medical
Edo Aarts Imran Abbas Luigi Angrisani Luciano Antozzi Tanseer Asghar Ahmad Bashir Estuardo Behrens Mohit Bhandari Aperna Bhasker Helmuth Billy Miguel-A
Lorenzo Mohamad Hayssam El Fawal Daniel Moritz Felsenreich Sigal Fishman Michael Gagner Manoel Galvao Khaled Gawdat Tikfu GEE Bijan Ghavami Ashraf Haddad Andres Hanssen Miguel F. Herrera Kelvin Higa Jacques M Himpens Kazunori Kasama Radwan Kassir Amir Khan Nesreen Khidir Mousa Khoursheed Haris Khwaja Lillian Kow Matt Kroh Kuldeepak Singh Kular
Ramon Villalonga Rudolf Weiner Sylvia Weiner Wah Yang Joerg Zehetner Natan Zundel
Spatz Medical
USGI
Johnson and Johnson
Medtronic

Keywords

Barrett’s esophagus
Esophagitis
GERD
Long-term complications
Marginal ulcers
OAGB
RYGB
Revisional bariatric surgery
SG

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s11695-023-06481-x

Cite this

@article{5c6082e45dfb4144a3346fb07f81dee6,

title = "Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery — an International Experts{\textquoteright} Survey",

abstract = "Objective: This study aimed to survey international experts in metabolic and bariatric surgery (MBS) to improve and consolidate perioperative interventions to prevent gastroesophageal reflux disease (GERD) and marginal ulcers (MU) after MBS. Background: Very important long-term complications after MBS include GERD, Barrett{\textquoteright}s esophagus, and MU. Prevention might be fundamental to reduce the incidence, severe complications, and the increasing number of revisional bariatric surgeries. Methods: An international scientific team designed an online confidential questionnaire with 45 multiple-choice questions. The survey was sent to 110 invited experts and 96 of them (from 41 different countries) participated from 21 July 2022 to 4 September 2022. Results: Most experts (≥ 90%) prescribe postoperative acid suppression agents after MBS. Life-long proton pump inhibitors prophylaxis in smokers with avoidance of non-steroidal anti-inflammatory drugs are recommended by most of the experts (66%, 73%) after any type of gastric bypass. Two-thirds of experts (69%) perform Helicobacter pylori eradication prior to MBS. Two-thirds of experts (68%) routinely perform EGD and biopsy before MBS. Follow-up esophagogastroduodenoscopy (EGD) and timing threshold for revisional and conversional MBS were variable among experts. Conclusion: This expert survey underlines important perioperative interventions that reached a two-thirds consensus among MBS international experts. Variability in follow-up EGD, approach to complication management, and thresholds for revisional and conversional MBS emphasize the need for further researches and consensus guidelines. Graphical Abstract: [Figure not available: see fulltext.]",

keywords = "Barrett{\textquoteright}s esophagus, Esophagitis, GERD, Long-term complications, Marginal ulcers, OAGB, RYGB, Revisional bariatric surgery, SG",

author = "{PGEMU collaborators} and Sonja Chiappetta and Christine Stier and Ghanem, {Omar M.} and Dayyeh, {Barham K.Abu} and Ivo Bo{\v s}koski and Gerhard Prager and Teresa LaMasters and Mohammad Kermansaravi and Edo Aarts and Imran Abbas and Luigi Angrisani and Luciano Antozzi and Tanseer Asghar and Ahmad Bashir and Estuardo Behrens and Mohit Bhandari and Aperna Bhasker and Helmuth Billy and Carbajo, {Miguel A.} and Chevallier, {Jean Marc} and Ricardo Cohen and Jerome Dargent and {De Luca}, Maurizio and {de Moura}, Eduardo and Bruno Dillemans and {Di Lorenzo}, Nicola and {Hayssam El Fawal}, Mohamad and Felsenreich, {Daniel Moritz} and Sigal Fishman and Michael Gagner and Manoel Galvao and Khaled Gawdat and Tikfu Gee and Bijan Ghavami and Ashraf Haddad and Andres Hanssen and Herrera, {Miguel F.} and Kelvin Higa and Himpens, {Jacques M.} and Kazunori Kasama and Radwan Kassir and Amir Khan and Nesreen Khidir and Mousa Khoursheed and Haris Khwaja and Lillian Kow and Matt Kroh and {Singh Kular}, Kuldeepak and Panagiotis Lainas and Nasser Sakran",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2023",

month = may,

doi = "10.1007/s11695-023-06481-x",

language = "אנגלית",

volume = "33",

pages = "1449--1462",

journal = "Obesity Surgery",

issn = "0960-8923",

publisher = "Springer",

number = "5",

}

TY - JOUR

T1 - Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery — an International Experts’ Survey

AU - PGEMU collaborators

AU - Chiappetta, Sonja

AU - Stier, Christine

AU - Ghanem, Omar M.

AU - Dayyeh, Barham K.Abu

AU - Boškoski, Ivo

AU - Prager, Gerhard

AU - LaMasters, Teresa

AU - Kermansaravi, Mohammad

AU - Aarts, Edo

AU - Abbas, Imran

AU - Angrisani, Luigi

AU - Antozzi, Luciano

AU - Asghar, Tanseer

AU - Bashir, Ahmad

AU - Behrens, Estuardo

AU - Bhandari, Mohit

AU - Bhasker, Aperna

AU - Billy, Helmuth

AU - Carbajo, Miguel A.

AU - Chevallier, Jean Marc

AU - Cohen, Ricardo

AU - Dargent, Jerome

AU - De Luca, Maurizio

AU - de Moura, Eduardo

AU - Dillemans, Bruno

AU - Di Lorenzo, Nicola

AU - Hayssam El Fawal, Mohamad

AU - Felsenreich, Daniel Moritz

AU - Fishman, Sigal

AU - Gagner, Michael

AU - Galvao, Manoel

AU - Gawdat, Khaled

AU - Gee, Tikfu

AU - Ghavami, Bijan

AU - Haddad, Ashraf

AU - Hanssen, Andres

AU - Herrera, Miguel F.

AU - Higa, Kelvin

AU - Himpens, Jacques M.

AU - Kasama, Kazunori

AU - Kassir, Radwan

AU - Khan, Amir

AU - Khidir, Nesreen

AU - Khoursheed, Mousa

AU - Khwaja, Haris

AU - Kow, Lillian

AU - Kroh, Matt

AU - Singh Kular, Kuldeepak

AU - Lainas, Panagiotis

AU - Sakran, Nasser

PY - 2023/5

Y1 - 2023/5

N2 - Objective: This study aimed to survey international experts in metabolic and bariatric surgery (MBS) to improve and consolidate perioperative interventions to prevent gastroesophageal reflux disease (GERD) and marginal ulcers (MU) after MBS. Background: Very important long-term complications after MBS include GERD, Barrett’s esophagus, and MU. Prevention might be fundamental to reduce the incidence, severe complications, and the increasing number of revisional bariatric surgeries. Methods: An international scientific team designed an online confidential questionnaire with 45 multiple-choice questions. The survey was sent to 110 invited experts and 96 of them (from 41 different countries) participated from 21 July 2022 to 4 September 2022. Results: Most experts (≥ 90%) prescribe postoperative acid suppression agents after MBS. Life-long proton pump inhibitors prophylaxis in smokers with avoidance of non-steroidal anti-inflammatory drugs are recommended by most of the experts (66%, 73%) after any type of gastric bypass. Two-thirds of experts (69%) perform Helicobacter pylori eradication prior to MBS. Two-thirds of experts (68%) routinely perform EGD and biopsy before MBS. Follow-up esophagogastroduodenoscopy (EGD) and timing threshold for revisional and conversional MBS were variable among experts. Conclusion: This expert survey underlines important perioperative interventions that reached a two-thirds consensus among MBS international experts. Variability in follow-up EGD, approach to complication management, and thresholds for revisional and conversional MBS emphasize the need for further researches and consensus guidelines. Graphical Abstract: [Figure not available: see fulltext.]

AB - Objective: This study aimed to survey international experts in metabolic and bariatric surgery (MBS) to improve and consolidate perioperative interventions to prevent gastroesophageal reflux disease (GERD) and marginal ulcers (MU) after MBS. Background: Very important long-term complications after MBS include GERD, Barrett’s esophagus, and MU. Prevention might be fundamental to reduce the incidence, severe complications, and the increasing number of revisional bariatric surgeries. Methods: An international scientific team designed an online confidential questionnaire with 45 multiple-choice questions. The survey was sent to 110 invited experts and 96 of them (from 41 different countries) participated from 21 July 2022 to 4 September 2022. Results: Most experts (≥ 90%) prescribe postoperative acid suppression agents after MBS. Life-long proton pump inhibitors prophylaxis in smokers with avoidance of non-steroidal anti-inflammatory drugs are recommended by most of the experts (66%, 73%) after any type of gastric bypass. Two-thirds of experts (69%) perform Helicobacter pylori eradication prior to MBS. Two-thirds of experts (68%) routinely perform EGD and biopsy before MBS. Follow-up esophagogastroduodenoscopy (EGD) and timing threshold for revisional and conversional MBS were variable among experts. Conclusion: This expert survey underlines important perioperative interventions that reached a two-thirds consensus among MBS international experts. Variability in follow-up EGD, approach to complication management, and thresholds for revisional and conversional MBS emphasize the need for further researches and consensus guidelines. Graphical Abstract: [Figure not available: see fulltext.]

KW - Barrett’s esophagus

KW - Esophagitis

KW - GERD

KW - Long-term complications

KW - Marginal ulcers

KW - OAGB

KW - RYGB

KW - Revisional bariatric surgery

KW - SG

UR - http://www.scopus.com/inward/record.url?scp=85148053877&partnerID=8YFLogxK

U2 - 10.1007/s11695-023-06481-x

DO - 10.1007/s11695-023-06481-x

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 36781593

AN - SCOPUS:85148053877

SN - 0960-8923

VL - 33

SP - 1449

EP - 1462

JO - Obesity Surgery

JF - Obesity Surgery

IS - 5

ER -

Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery — an International Experts’ Survey

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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