Sleeve Gastrectomy with Roux-en-y Transit Bipartition versus Sleeve Gastrectomy for the Treatment of Obesity and Reflux: A Multicenter Randomized Controlled Trial
In brief
Transit-bipartition surgery lowered new reflux from 28% to 3% at one year
In a 120-patient pilot randomized trial, new gastroesophageal reflux occurred in 3.3% of patients after sleeve gastrectomy with transit bipartition, compared with 28.3% after standard sleeve surgery. The transit-bipartition group also lost more weight, but participants were carefully selected and the study followed them for only 12 months; longer-term reflux and nutritional safety remain unknown.
- Journal
- Obesity surgery (Q1)
- Published
- 24 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Vincenzo Consalvo, Sofia Guadalupe Rodriguez, Federica Galli, Andrea Gambetti, Vincenzo Salsano, Marco Antonio Zappa, et al.
- PMID
- 42782492
- DOI
- 10.1007/s11695-026-08949-y
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 25 September 2026): SG‑TB lower de novo GERD vs SG at 12 months
Abstract
BACKGROUND: Laparoscopic Sleeve Gastrectomy (SG) is associated with a significant risk of de novo or worsening Gastroesophageal Reflux Disease (GERD). Sleeve Gastrectomy with Roux- en-y Transit Bipartition (SG-TB) has been proposed as an alternative procedure to mitigate reflux. This study aims to compare the efficacy and safety of SG versus SG-TB in controlling GERD in patients with obesity. METHODS: A multicenter, prospective, pilot randomized controlled trial (ID: researchregistry11842) was conducted in three high- volume bariatric centers. A total of 120 patients with obesity were randomized to either SG (n = 60) or SG-TB (n = 60). The methodological core was the assessment of GERD, based on 24- hour pH-impedance monitoring performed at baseline and at 12 months. RESULTS: At 12 months, the SG-TB group showed a significantly lower incidence of de novo GERD compared to the SG group (3.3% vs. 28.3%; p < 0.001). At 12 months, mean Acid Exposure Time (AET) was significantly lower after SG-TB than after SG (1.9% vs. 7.5%, p < 0.001) and remained numerically unchanged from the SG-TB baseline value of 1.9%. The SG-TB group also demonstrated a higher % of total weight loss and % Excess Weight Loss (%TWL: p < 0.001; %EWL: p = 0.002). CONCLUSIONS: In this multicenter pilot RCT, SG-TB was associated with a significantly lower incidence of de novo GERD compared to SG at 12 months in carefully selected patients without severe pre-existing GERD. These short-term findings are encouraging; however, definitive conclusions regarding the superiority of SG-TB cannot be drawn on the basis of 12- month data alone. Longer follow-up is required to assess the durability of reflux outcomes, late nutritional safety, and late GERD relapse.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.