Surgical Management of Gastroesophageal Reflux Disease in Obesity
- 29 July 2008
- journal article
- Published by Springer Science and Business Media LLC in Digestive Diseases and Sciences
- Vol. 53 (9), 2318-2329
- https://doi.org/10.1007/s10620-008-0415-7
Abstract
Bariatric surgery is ubiquitous today. In the obese patient with comorbid gastroesophageal reflux disease (GERD), it is increasingly being used as an alternative to fundoplication because it not only has an effect on GERD but also on other comorbid illnesses. Traditional GERD surgery is designed to augment the mechanical barriers against reflux, decrease acid production in the stomach, improve gastric emptying, or divert bile from the stomach. Roux-en-Y gastric bypass addresses these issues in addition to resulting in profound weight loss in patients. Banding may have a positive influence in patients’ GERD, though to a lesser extent. The duodenal switch provides excellent control for patients with alkaline reflux. A revision of the 1991 National Institutes of Health guidelines for determining bariatric surgical candidates is overdue, and it may be feasible to consider expanding the body mass index and comorbidity requirements to reflect the benefits offered by these techniques for GERD patients.Keywords
This publication has 55 references indexed in Scilit:
- Long-Term Mortality after Gastric Bypass SurgeryNew England Journal of Medicine, 2007
- Effects of Bariatric Surgery on Mortality in Swedish Obese SubjectsNew England Journal of Medicine, 2007
- Who will fail laparoscopic Nissen fundoplication? Preoperative prediction of long-term outcomesSurgical Endoscopy, 2007
- Prospective Trial of Laparoscopic Nissen Fundoplication Versus Proton Pump Inhibitor Therapy for Gastroesophageal Reflux Disease: Seven-Year Follow-upJournal of Gastrointestinal Surgery, 2006
- Treatment of refractory gastroesophageal reflux disease with radiofrequency energy (Stretta) in patients after Roux-en-Y gastric bypassSurgical Endoscopy, 2006
- Complications and Antireflux Medication Use After Antireflux SurgeryClinical Gastroenterology and Hepatology, 2006
- Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypassSurgical Endoscopy, 2002
- Laparoscopic resection of a large periadrenal nonmalignant pheochromocytomaSurgical Endoscopy, 2001
- Obesity adversely affects the outcome of antireflux operationsSurgical Endoscopy, 2001
- Experimental and Clinical Results with Proximal End-to-End Duodenojejunostomy for Pathologic Duodenogastric RefluxAnnals of Surgery, 1987