Meta-analysisindependent cross-checkabstract checked I-BAR-112 standard review
How often reflux disease develops after sleeve
Incidence of Post-operative Gastro-esophageal Reflux Disorder in Patients Undergoing Laparoscopic Sleeve Gastrectomy: A Systematic Review and Meta-analysis.
Overview
Trujillo et al.. Obes Surg 2024 · PMID 38483740 · DOI 10.1007/s11695-024-07163-y
About 1 in 3 patients developed reflux disease after sleeve (about 6 in 10 in trials with systematic testing).
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Incidence of GERD after LSG
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
20,495
- What was actually found?
35% overall
- How large was the observed effect?
Proportion 0.35
- What do the results mean in everyday life?
Reflux is common
- What are the study's limitations?
Very heterogeneous
- What does it say about Elawady's specific claim?
Supports reflux claim; not "inevitable"
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Severity
Scientific in-depth review
1. Full reference
- Authors
- Trujillo et al.
- Journal
- Obes Surg
- Year
- 2024
- Identifier
- PMID 38483740 DOI 10.1007/s11695-024-07163-y
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref API
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
What proportion of patients develop GERD after laparoscopic sleeve gastrectomy?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of observational studies and clinical trials
- Population
Patients after LSG
- Country
Multinational
- Period
not stated in abstract
- Sample size
22 studies, 20,495 participants
- Inclusion and exclusion criteria
Observational studies and trials reporting post-LSG GERD
4. Methods and endpoints
- Exposure / intervention
LSG
- Comparator
None
- Endpoints
Post-operative GERD
- Statistical methods
Random-effects proportion meta-analysis
5. Actual results
- Results
Proportion developing post-surgery GERD 0.35 (0.30-0.41); observational 0.33 (0.27-0.38); clinical trials 0.58 (0.39-0.75); I2 98%.
- Absolute risks
About 35 in 100 developed GERD.
- Authors' conclusion
Moderate to high risk of developing GERD after LSG.
6. Strengths
- Large sample
7. Weaknesses
- Extreme heterogeneity (I2 98%)
- Definitions vary
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Overlap with other meta-analyses.
9. Assessment of the statistical interpretation
Higher proportion in trials likely reflects systematic assessment.
10. Relevance to the specific claim
Supports frequent GERD after sleeve; even the upper estimates are well below 100%.
11. Independent contrary findings
Heterogeneous.
12. Transferability to Germany and Europe
International.
13. Overall methodological judgement
Supports "common", contradicts "inevitable".
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Standard definitions.
15. Linked fact checks
- Sleeve gastrectomy substantially increases gastro-oesophageal reflux disease and erosive oesophagitis. – Studies supporting the claim
- After sleeve gastrectomy reflux is inevitable, and patients must take acid-suppressing drugs for life. – Studies contradicting or limiting the claim