Associations between sleeve gastrectomy, cholecystectomy, and gastroesophageal reflux disease in obese patients: an integrative review

Adaptations of the gastrointestinal tract after sleeve gastrectomy have been associated with an increased incidence of gastroesophageal reflux disease (GERD) and cholelithiasis. Associations between GERD and increased enterohepatic biliary circulation post-cholecystectomy have been demonstrated. The objective of this study was to analyze the possible associations between cholecystectomy, sleeve gastrectomy and gastroesophageal reflux disease in obese patients. This is an integrative review of the literature, selecting full publications, published in Portuguese, English and Spanish, between 2010 and 2023, in the databases: Web of Science, MEDLINE, LILACS, EMBASE and IBECS. The initial sample consisted of 783 studies, of which nine were selected for analysis. The synthesis of the selected articles showed that in the post-sleeve gastrectomy follow-up, 32.9% of patients developed cholelithiasis, considering 17.1% in the symptomatic form, with 15.4% of the sample undergoing cholecystectomy. The development of GERD after cholecystectomy was evident in 53.6% of patients. Evidence from current literature suggests a relationship between GERD and patients undergoing sleeve gastrectomy and cholecystectomy procedures. The causal mechanism appears multifactorial, especially linked to anatomical, metabolic and physiological changes resulting from surgical interventions. Therefore, more studies are needed to better elucidate the outcomes and effects on the gastrointestinal dynamics that permeate this condition.