Revista do Colégio Brasileiro de Cirurgiões
https://revistadocbc.org.br/article/doi/10.1590/0100-6991e-20253793
Revista do Colégio Brasileiro de Cirurgiões
Artigo de Revisão

Associações entre gastrectomia vertical, colecistectomia e doença do refluxo gastroesofágico em pacientes obesos: Revisão integrativa

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

Gabriel Guerra Cordeiro; Vinícius Vasconcelos do Amaral; Luiz Alberto Reis Mattos Júnior; Matheus Calixto Lemos; Flávio Kreimer; José Guido Correia de Araújo Júnior; Álvaro A. B. Ferraz

http://dx.doi.org/10.1590/0100-6991e-20253793 RCBC, vol.52, e20253793, 2025
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Resumo

Introdução: As adaptações do trato gastrointestinal após a remodelação decorrente da gastrectomia vertical têm sido associadas ao aumento da incidência da doença do refluxo gastroesofágico (DRGE) e da colelitíase. Evidências correlacionam a DRGE e o aumento da circulação biliar entero-hepática pós-colecistectomia. O objetivo deste estudo consistiu em analisar as possíveis associações entre colecistectomia, gastrectomia vertical e doença do refluxo gastroesofágico em pacientes obesos.

Métodos: Trata-se de uma revisão integrativa da literatura, sendo selecionadas publicações na íntegra, publicadas em português, inglês e espanhol, entre 2010 e 2023, nas bases de dados: Web of Science, MEDLINE, LILACS, EMBASE e IBECS. A amostra inicial constituiu-se de 783 estudos, dos quais nove foram selecionados para análise.

Resultados: A síntese dos artigos selecionados evidenciou que no seguimento pós-gastrectomia vertical, 32,9% dos pacientes desenvolveram colelitíase, considerando-se 17,1% na forma sintomática, sendo 15,4% da amostra submetidos à colecistectomia. Evidenciou-se o desenvolvimento de DRGE após colecistectomia em 53,6% dos pacientes.

Conclusão: As evidências da literatura atual sugerem uma relação entre DRGE e os pacientes submetidos aos procedimentos de gastrectomia vertical e colecistectomia. O mecanismo de causalidade parece multifatorial, sobretudo atrelado às modificações anatômicas, metabólicas e fisiológicas decorrentes das intervenções cirúrgicas. Dessa forma, mais estudos são necessários para melhor elucidar os desfechos e efeitos na dinâmica gastrointestinal que permeiam essa condição.

Palavras-chave

Gastrectomia Vertical; Cirurgia Bariátrica; Colecistectomia; Doença do Refluxo Gastroesofágico; Obesidade

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords

Sleeve Gastrectomy; Bariatric Surgery; Cholecystectomy; Gastroesophageal Reflux Disease; Obesity

Referências

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Submetido em:
08/07/2024

Aceito em:
08/07/2025

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