Background: Roux-en-Y gastric bypass (RYGB) is considered the weight loss procedure of choice for obese patients with gastroesophageal reflux disease (GORD). The long-term prevalence of GORD after RYGB for obesity is underestimated as many post-RYGB patients can still complain of severe reflux symptoms, refractory to medications.
Methods: This is a narrative review using the patient, intervention, comparison, outcome and study strategy. The literature search was undertaken using PubMed, Medline, and Google Scholar databases with the following MeSH terms: Gastroesophageal reflux disease, GORD, Obesity, Gastric bypass, Roux-en-Y gastric bypass, complication, and fundoplication.
Results: Twelve original papers and case report studies on 57 patients who met the inclusion criteria were suitable for the present review. Reporting styles on successful treatment outcomes were heterogeneous. Treatment options for these patients are limited but include further surgical or endoscopic interventions. Careful follow-up and appropriate management are paramount for this population.
Conclusion: There is significant paucity in the available evidence on managing GORD after RYGB. This narrative review provides a detailed overview of the underlying causes, discusses the various endoscopic and surgical therapy options, and suggests strategies to provide tailored and appropriate therapy for this complex group of patients.
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http://dx.doi.org/10.1177/15533506241292707 | DOI Listing |
Scand J Gastroenterol
January 2025
Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Xiamen Branch, Xiamen, China.
Background: Evaluate the clinical significance of esophagogastric junction (EGJ) morphology and esophagogastric junction contractile integral (EGJ-CI) in refractory gastroesophageal reflux disease (RGERD) patients.
Methods: From June 2021 to June 2023, 144 RGERD patients underwent comprehensive evaluation, recording symptom scores, demographic data. GERD classification (NERD or RE, A-D) was based on endoscopic findings.
Surg Endosc
January 2025
Faculty of Medicine, Pediatric Surgery, Tanta University Hospital, Tanta, 31527, Egypt.
Background: Surgical fundoplication remains integral in managing gastroesophageal reflux disease (GERD) by addressing gastroesophageal valve incompetence. This study introduces a novel hybrid approach, the Eversion Cruroplasty and Collar Overwrap (ECCO) procedure, aiming to combine benefits of conventional partial wrapping and posteromedial cardiopexy, considering gastric fundus anatomical peculiarities as an anti-reflux barrier.
Methods: A retrospective analysis of pediatric patients presenting with refractory GERD from 2021 to 2023 was conducted.
Cureus
December 2024
Department of Hepatobiliary and Pancreatic Surgery, Pontificia Universidad Católica de Chile, Santiago, CHL.
Pancreatoduodenectomy and distal pancreatectomy are standard treatments for various pancreatic pathologies. These procedures involve radical resection and a significant loss of pancreatic tissue, which can lead to exocrine and/or endocrine pancreatic insufficiency. In selected cases of benign tumors or those with low malignant potential, central pancreatectomy can be performed with acceptable morbidity and mortality rates.
View Article and Find Full Text PDFNeurogastroenterol Motil
January 2025
Division of Gastroenterology, University of Pisa, Pisa, Italy.
Introduction: High-resolution manometry (HRM) allows assessment of esophagogastric junction (EGJ) disruption. While type 3 EGJ predicts definitive gastroesophageal reflux disease (GERD), type 2 EGJ is less clearly implicated in GERD pathogenesis. This study aimed to characterize physiologic findings in type 2 EGJ to determine if the HRM-based Milan Score can define GERD within type 2 EGJ.
View Article and Find Full Text PDFAsian Pac J Allergy Immunol
December 2024
Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, T hailand.
Chronic cough is a common clinical condition requiring comprehensive assessment. This review employs a symptom-focused approach, prioritizing the presenting symptom of "chronic cough" to mirror real-world clinical practice. Ten key questions regarding the investigations in the uncertain areas were systematically addressed based on the PICO framework and applying the GRADE system for evidence synthesis to provide the strength of recommendation and quality of evidence for key questions.
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