SP9.14 - Gastro-oesophageal reflux disease outcomes in patients with obesity following gastric bypass surgery: a systematic review and meta-analysis

Abstract

Abstract Introduction Obesity is associated with increased incidence of gastro-oesophageal reflux disease (GORD). Gastric bypass is one of the most common bariatric procedures and has favourable weight loss outcomes leading to a decrease in morbidity and mortality. However, the exact impact of gastric bypass on GORD symptoms remains less well understood. This systematic review and meta-analysis aimed to investigate the relationship between gastric bypass surgery and GORD. Methods A literature search of MEDLINE, Embase, Emcare and CINAHL was performed for studies that reported on GORD outcomes following gastric bypass from January 2000 to June 2023. Meta-analysis was performed using random-effect models and between-study heterogeneity was assessed. The study was registered in the PROSPERO database (CRD42023495567). Results 16 studies with 28,438 patients (follow-up ranging from 6-100 months), with laparoscopic Roux-en-Y gastric bypass being the most common procedure performed (25,567; 90%). The mean operative time for gastric bypass was 101 ± 14.0 minutes, with a re-operation rate of 0.025% ± 0.005. Sixty percent of patients permanently stopped proton-pump inhibitors following surgery. Overall, gastric bypass surgery led to a significant improvement in GORD symptoms (OR 5.31%; 95% CI: 1.77-15.91; p<0.003), with a postoperative mortality rate of 0.037% ± 0.009. Conclusions The findings of this systematic review and meta-analysis showed that gastric bypass surgery is an effective and safe treatment for GORD. This has significant implications for counselling patients with obesity and GORD for bariatric surgery. Further research is required to understand the precise mechanism of the improvement in GORD symptoms following bariatric surgery.