Laparoscopic sleeve gastrectomy and gastroesophageal reflux

Table 1 Symptoms of gastroesophageal reflux disease

	GERD in obesity	De novo GERD after SG	Improvement of GERD after SG
Mechanism	Increasing BMI	Lack of gastric compliance	Reduced intra-abdominal pressure
	Increasing intragastric pressure	Increased intraluminal pressure	Reduced acid production
	Increasing gastroesophageal pressure gradient	Gastric fundus removal	Accelerated gastric emptying
	Hiatal hernia	LES pressure	Reduced gastric volume
		Final shape of the sleeve
		Narrowing at the junction of the vertical and horizontal parts of the sleeve
		Twisting of the sleeve
		Dilation of the fundus
		Persistence of hiatal hernia

GERD: Gastroesophageal reflux disease; SG: Sleeve gastrectomy.