We have read Dr De Tomás’1 letter with great interest, and we fully agree with his comments. To answer the questions posed, the patient had a BMI of 27.9 with very significant GERD symptoms that were continuous and did not respond to PPI treatment. Using the visual analog scale, the symptoms were assessed as 10 out of 10. Under these conditions, we opted to perform laparoscopic gastric bypass with a 100-cm alimentary limb and a 50-cm biliopancreatic limb. Six months later, the patient was asymptomatic, with a BMI of 24.8.
Regarding the second question: what to do with an asymptomatic young woman with a BMI < 30 kg/m2 after SG, diagnosed years later with short-segment BE without dysplasia?
We agree that the decision in this second case is more complex and controversial. Our team would be more in favor of conversion to bypass, as PPI do not control alkaline reflux. With no current solid scientific evidence on the best treatment, we accept that this case lends itself to discussion and personalized treatment.
Please cite this article as: Lucas Guerrero V, Luna A, Rebasa P, Montmany S, Navarro S. Réplica al manuscrito «Reconversión a bypass gástrico en pacientes con esófago de Barret tras una gastrectomía vertical». Cir Esp. 2021;99:398–399.
