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

PGEMU collaborators

Research output: Contribution to journalArticlepeer-review

6 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 languageEnglish
Pages (from-to)1449-1462
Number of pages14
JournalObesity Surgery
Volume33
Issue number5
DOIs
StatePublished - 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

FundersFunder 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

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