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Introduction <p>Sleeve gastrectomy (SG) has become the most frequent bariatric surgery procedure. Secondary gastroesophageal reflux (GERD) may indicate conversion to Roux-en-Y gastric bypass (RYGB). However, in patients with sufficient weight loss, there is no clear answer in the literature as to whether RYGB should be performed with loop lengths leading to metabolic effect, or whether it should be performed solely for anti-reflux purposes. We aimed to evaluate current surgical practices and limb-length preferences among French-speaking bariatric surgeons managing GERD after SG in patients with satisfactory weight loss.</p> Methods <p>A cross-sectional survey was distributed to members of the Société Française et Francophone de Chirurgie de l'Obésité et des Maladies Métaboliques (SOFFCO-MM). The questionnaire included demographics, criteria for “satisfactory weight loss”, diagnostic workup for GERD and RYGB technical configurations.</p> Results <p>Fifty-three surgeons responded. Only 22.6% reported using a “standard” French RYGB configuration: alimentary limb (AL) 140-150 cm, biliary limb (BL) 70-80 cm). Most surgeons (60%) do not adjust the AL length based on weight loss, while 74% do not adjust the BL. Diagnostic approaches varied: 40% routinely performed pH monitoring, and only three surgeons required manometry.</p> Conclusions <p>While the majority of surgeons do choose RYGB to manage GERD after SG in patients with satisfactory weight loss, only a minority follow a strictly “standard” configuration (AL 140-150 cm, BL 70-80 cm). This indicates notable variability in limb-length selection, underscoring the need for more harmonized approaches and clearer guidelines.</p>

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Surgical management of gastroesophageal reflux disease after sleeve gastrectomy with satisfactory weight loss: a SOFFCO-MM practice survey

  • 期刊论文

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  • 发表日期：

    2026年5月20日

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  • Francesco Abboretti,
  • Tigran Poghosyan,
  • Styliani Mantziari,
  • François Pattou,
  • Andrea Lazzati,
  • Marie-Cécile Blanchet,
  • Claire Blanchard,
  • Jean-Marc Catheline,
  • Laurent Genser,
  • Fabian Reche,
  • Maud Robert,
  • Caroline Gronnier,
  • Damien Bouriez

摘要

Introduction

Sleeve gastrectomy (SG) has become the most frequent bariatric surgery procedure. Secondary gastroesophageal reflux (GERD) may indicate conversion to Roux-en-Y gastric bypass (RYGB). However, in patients with sufficient weight loss, there is no clear answer in the literature as to whether RYGB should be performed with loop lengths leading to metabolic effect, or whether it should be performed solely for anti-reflux purposes. We aimed to evaluate current surgical practices and limb-length preferences among French-speaking bariatric surgeons managing GERD after SG in patients with satisfactory weight loss.

Methods

A cross-sectional survey was distributed to members of the Société Française et Francophone de Chirurgie de l'Obésité et des Maladies Métaboliques (SOFFCO-MM). The questionnaire included demographics, criteria for “satisfactory weight loss”, diagnostic workup for GERD and RYGB technical configurations.

Results

Fifty-three surgeons responded. Only 22.6% reported using a “standard” French RYGB configuration: alimentary limb (AL) 140-150 cm, biliary limb (BL) 70-80 cm). Most surgeons (60%) do not adjust the AL length based on weight loss, while 74% do not adjust the BL. Diagnostic approaches varied: 40% routinely performed pH monitoring, and only three surgeons required manometry.

Conclusions

While the majority of surgeons do choose RYGB to manage GERD after SG in patients with satisfactory weight loss, only a minority follow a strictly “standard” configuration (AL 140-150 cm, BL 70-80 cm). This indicates notable variability in limb-length selection, underscoring the need for more harmonized approaches and clearer guidelines.