Alzanbagi A, Qureshi LA, Khan MS, Alotaibi S, Tashkhandi A, Alzahrani S, Eliouny MA, ElBahrawy A, Khogeer A, Hazazi M, Hezry S, Fatani F, Shariff MK. Prevalence of Barrett’s esophagus and gastroesophageal reflux disease 5 years after laparoscopic sleeve gastrectomy: A retrospective study. World J Gastrointest Surg 2025; 17(8): 105607 [DOI: 10.4240/wjgs.v17.i8.105607]
Corresponding Author of This Article
Mohammed K Shariff, MD, Department of Gastroenterology and Hepatology, King Abdullah Medical City, Muzdalifah Road, Makkah 21955, Saudi Arabia. shariff.m@kamc.med.sa
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 105607 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.105607
Prevalence of Barrett’s esophagus and gastroesophageal reflux disease 5 years after laparoscopic sleeve gastrectomy: A retrospective study
Adnan Alzanbagi, Laeeque A Qureshi, Mohammed S Khan, Salem Alotaibi, Abdulaziz Tashkhandi, Saad Alzahrani, Mahmoud A Eliouny, Aly ElBahrawy, AlWahhaj Khogeer, Mohammed Hazazi, Suhail Hezry, Feras Fatani, Mohammed K Shariff
Adnan Alzanbagi, Laeeque A Qureshi, Mohammed S Khan, Salem Alotaibi, Abdulaziz Tashkhandi, Saad Alzahrani, Mahmoud A Eliouny, Mohammed K Shariff, Department of Gastroenterology and Hepatology, King Abdullah Medical City, Makkah 21955, Saudi Arabia
Aly ElBahrawy, AlWahhaj Khogeer, Department of Bariatric Surgery, King Abdullah Medical City, Makkah 21955, Saudi Arabia
Mohammed Hazazi, Suhail Hezry, Department of Internal Medicine, Umm Ul Qura University, Makkah 21955, Saudi Arabia
Feras Fatani, Department of Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 23046, Saudi Arabia
Author contributions: Alzanbagi A, Qurashi LA, and Shariff MK participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data; Qurashi LA and Shariff MK wrote the manuscript; Hazazi M, Hezry S, and Fatani F were involved in the data acquisition; Alzahrani S and Eliouny MA helped with the data interpretation; ElBahrawy A and Khogeer A were involved in the conception and design of the study; Khan MS, Alotaibi S, and Tashkhandi A accessed and verified the study data; All authors critically reviewed and provided final approval of the manuscript, and were responsible for the decision to submit the manuscript for publication.
Institutional review board statement: This study was conducted in accordance with the ethical standards approved by the Hospital Institutional Review Board (No. 18-491) that has been accredited by the Association for the Accreditation of Human Research Protection Program.
Informed consent statement: Given the retrospective nature of the study, patient consent was waived by the ethics board.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Data will be made available by the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed K Shariff, MD, Department of Gastroenterology and Hepatology, King Abdullah Medical City, Muzdalifah Road, Makkah 21955, Saudi Arabia. shariff.m@kamc.med.sa
Received: January 30, 2025 Revised: April 3, 2025 Accepted: June 12, 2025 Published online: August 27, 2025 Processing time: 208 Days and 4.2 Hours
Abstract
BACKGROUND
Obesity is a significant global health concern, with laparoscopic sleeve gastrectomy (LSG) being the most commonly performed bariatric surgery in the Middle East, including Saudi Arabia, due to its simplicity and effectiveness in achieving weight loss. However, the long-term effects of LSG on gastroesophageal reflux disease (GERD) and Barrett’s esophagus (BE) remain areas of active investigation.
AIM
To determine the prevalence of GERD and BE 5 years post-LSG in a Saudi Arabian population.
METHODS
A retrospective cohort study was conducted at a tertiary bariatric referral center in Saudi Arabia. Patients who underwent LSG 5 years prior and completed postoperative gastroscopy were included. Data on demographics, comorbidities, GERD symptoms, and endoscopic findings were extracted. GERD was defined clinically, esophagitis was graded per the Los Angeles classification, and BE was defined histologically. Multivariate logistic regression was used to identify predictors of GERD, endoscopic esophagitis (EE), and BE.
RESULTS
The study included 114 patients (mean age: 44 years; 61% female). GERD prevalence increased from 16% preoperatively to 64% 5 years post-LSG, with 54% of cases representing de novo GERD. EE prevalence rose to 30%, with 23% of cases being de novo. BE was detected in 2.6% of patients, all presenting with short-segment BE without intestinal metaplasia. On univariate analysis, the pre-LSG body mass index was significantly associated with EE (P = 0.038), and age was significantly associated with BE (P = 0.037). However, on multivariate analysis, only hypertension was independently associated with GERD development (odds ratio = 5.09; P = 0.01). No factors were significantly associated with EE or BE on multivariate analysis.
CONCLUSION
This study highlights the significant increase in GERD and EE prevalence 5 years post-LSG, with a relatively low but notable incidence of BE. The findings underscore the need for long-term endoscopic surveillance, particularly for older patients, even in populations with lower baseline
Core Tip: This retrospective single-center observational study investigated the prevalence of esophageal disorders 5 years post-laparoscopic sleeve gastrectomy (LSG) in a Saudi Arabian population. The study revealed a significant increase in gastroesophageal reflux disease from 16% to 64%, with 54% being de novo cases, and endoscopic esophagitis rising to 30%. While Barrett’s esophagus (BE) remains rare (2.6%), the findings highlight the need for long-term endoscopic surveillance, particularly for older patients and those with hypertension. This research provides critical insights into the post-LSG risks of esophageal disorders in a region with traditionally low BE prevalence.
