A recent large-scale study comparing sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) found that sleeve gastrectomy poses a significantly higher risk for Barrett’s esophagus (BE) one year after the procedure, with the risk increasing over time. The study also found that gastroesophageal reflux disease (GERD) symptoms were more closely linked to sleeve gastrectomy than RYGB. To gather evidence from a larger sample size, researchers analyzed data from over 100,000 patients who underwent either procedure. The results showed that the rate of BE at one year was significantly higher in the sleeve gastrectomy group, as was the incidence of GERD. The risk for BE continued to increase over time in patients who underwent sleeve gastrectomy compared to those who had RYGB. Patients who underwent endoscopic evaluation after sleeve gastrectomy had high rates of BE that increased over time, further strengthening the association between sleeve gastrectomy and BE. The study suggests that current guidelines for endoscopic evaluation after bariatric surgery should be strengthened, particularly for patients who have undergone sleeve gastrectomy. However, the study does not provide information on the appropriate interval for BE screening or whether there are high-risk patients who should be screened more frequently. It is also unclear whether RYGB might be a better choice for patients with a history of GERD or BE. Overall, this study is an important step in addressing the relationship between sleeve gastrectomy and BE as a complication of bariatric surgery.

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