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Background <p>Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure worldwide; however, concerns persist regarding the development of de novo gastroesophageal reflux disease (GERD) after surgery. Sleeve gastrectomy with transit bipartition (SG-TB) has emerged as a potential alternative, aiming to reduce GERD incidence while achieving superior weight loss outcomes. This study aimed to compare short-term outcomes of GERD, weight loss, and perioperative safety between SG and SG-TB.</p> Methods <p>A retrospective cohort study was conducted with 215 patients who underwent SG (n = 100) or SG-TB (n = 115) between January and December 2022. Eligible patients were aged 16–65&#xa0;years with a body mass index (BMI) of ≥ 27.5&#xa0;kg/m<sup>2</sup> (with type 2 diabetes) or ≥ 32.5&#xa0;kg/m<sup>2</sup>. GERD incidence was evaluated using the gastroesophageal reflux disease questionnaire (GERD-Q) and endoscopy 12&#xa0;months after surgery. Weight loss was measured by percentage total weight loss (%TWL) and percentage excess weight loss (%EWL). Operative time, estimated blood loss, length of hospital stay, and 30-day postoperative complications were also compared.</p> Results <p>At 12&#xa0;months, the SG-TB group demonstrated superior weight loss (%EWL: 112.0 ± 38.2% vs. 97.2 ± 25.5%, <i>p</i> = 0.001; %TWL: 33.8 ± 7.4% vs. 31.1 ± 6.4%, <i>p</i> = 0.006). The incidence of GERD was significantly lower in the SG-TB group (7.0% vs. 29.0%, <i>p</i> &lt; 0.001). Multivariate regression analysis identified SG as an independent risk factor for developing de novo GERD postoperatively (OR 4.536, 95% CI 1.787–11.519, <i>p</i> = 0.001). SG-TB was associated with longer operative time but showed comparable early postoperative safety to SG.</p> Conclusions <p>SG-TB significantly reduced the risk of postoperative GERD and resulted in superior short-term weight loss compared to SG, without increasing perioperative complication rates. Further multicenter, long-term studies are needed to validate these findings.</p> Graphical abstract <p></p>

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Incidence of de novo gastroesophageal reflux disease following sleeve gastrectomy versus sleeve gastrectomy with transit bipartition: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Jian Wang,
  • Liangchen Ni,
  • Tianci Li,
  • Wanjie Wang,
  • Wenchao Song,
  • Fidele Kakule Kitaghenda,
  • Jian Hong,
  • Xiaocheng Zhu,
  • Libin Yao

摘要

Background

Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure worldwide; however, concerns persist regarding the development of de novo gastroesophageal reflux disease (GERD) after surgery. Sleeve gastrectomy with transit bipartition (SG-TB) has emerged as a potential alternative, aiming to reduce GERD incidence while achieving superior weight loss outcomes. This study aimed to compare short-term outcomes of GERD, weight loss, and perioperative safety between SG and SG-TB.

Methods

A retrospective cohort study was conducted with 215 patients who underwent SG (n = 100) or SG-TB (n = 115) between January and December 2022. Eligible patients were aged 16–65 years with a body mass index (BMI) of ≥ 27.5 kg/m2 (with type 2 diabetes) or ≥ 32.5 kg/m2. GERD incidence was evaluated using the gastroesophageal reflux disease questionnaire (GERD-Q) and endoscopy 12 months after surgery. Weight loss was measured by percentage total weight loss (%TWL) and percentage excess weight loss (%EWL). Operative time, estimated blood loss, length of hospital stay, and 30-day postoperative complications were also compared.

Results

At 12 months, the SG-TB group demonstrated superior weight loss (%EWL: 112.0 ± 38.2% vs. 97.2 ± 25.5%, p = 0.001; %TWL: 33.8 ± 7.4% vs. 31.1 ± 6.4%, p = 0.006). The incidence of GERD was significantly lower in the SG-TB group (7.0% vs. 29.0%, p < 0.001). Multivariate regression analysis identified SG as an independent risk factor for developing de novo GERD postoperatively (OR 4.536, 95% CI 1.787–11.519, p = 0.001). SG-TB was associated with longer operative time but showed comparable early postoperative safety to SG.

Conclusions

SG-TB significantly reduced the risk of postoperative GERD and resulted in superior short-term weight loss compared to SG, without increasing perioperative complication rates. Further multicenter, long-term studies are needed to validate these findings.

Graphical abstract