Barrett’s esophagus after sleeve gastrectomy: a systematic review and meta-analysis

Background and Aims Sleeve gastrectomy (SG) has seen significant growth in recent years. Gastroesophageal reflux disease (GERD) is a major concern in patients undergoing SG and is the major risk factor for Barrett's esophagus (BE). We aimed to assess the prevalence of BE in patients who had SG. Methods We searched major search engines ending in July 2020. We included studies on patients who had esophagogastroduodenoscopy (EGD) after SG. The primary outcome was the prevalence of BE in patients who had SG. We assessed heterogeneity using I2 and Q statistics. We used funnel plots and classic fail-safe to assess for publication bias. We used random-effects modeling to report effect estimates. Results Our final analysis included 10 studies totaling 680 patients who had EGD 6 months to 10 years after SG. The pooled prevalence of BE was 11.6% (95% CI, 8.1 -16.4%; p Conclusions The prevalence of BE in patients who had EGD after SG appears to be high. There was no correlation with GERD symptoms. Most cases were observed after 3 years of follow-up. Screening for BE should be considered in patients after SG even in the absence of GERD symptoms postoperatively.