Obesity is a strong risk factor for Barrett's esophagus (BE), the only proven precursor lesion to esophageal adenocarcinoma (EAC). Bariatric surgery is currently the only reliable treatment that achieves long‐term sustained weight loss; however, it can markedly affect the development of de novo BE, and the progression or regression of existing BE. Bariatric procedures may also have implications on future surgical management of any consequent EAC. In this review, we examine the current evidence and published guidelines for BE in bariatric surgery. Current screening practices before bariatric surgery vary substantially, with conflicting recommendations from bariatric societies. If diagnosed, the presence of BE may alter the type of bariatric procedure. A selective screening approach prevents unnecessary endoscopy; however, there is poor symptom correlation with disease. Studies suggest that sleeve gastrectomy predisposes patients to gastroesophageal reflux and de novo BE. Conversely, Roux‐en‐Y gastric bypass is associated with decreased reflux and potential improvement or resolution of BE. There are currently no guidelines addressing the surveillance for BE following bariatric surgery. BE is an important consideration in the management of bariatric surgical patients. Evidence‐based recommendations are required to guide procedure selection and postoperative surveillance.

中文翻译：

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减肥手术患者巴雷特食管的围手术期筛查、管理和监测

肥胖是 Barrett 食管 (BE) 的重要危险因素，这是唯一经证实的食管腺癌 (EAC) 前驱病变。减肥手术是目前唯一能实现长期持续减肥的可靠治疗方法；然而，它会显着影响新 BE 的发展，以及现有 BE 的进展或退化。减肥手术也可能对任何后续 EAC 的未来手术管理产生影响。在这篇综述中，我们检查了当前的证据和已发表的减肥手术 BE 指南。目前减肥手术前的筛查实践差异很大，减肥协会的建议相互矛盾。如果确诊，BE 的存在可能会改变减肥手术的类型。选择性筛查方法可防止不必要的内窥镜检查；然而，症状与疾病的相关性较差。研究表明袖状胃切除术使患者易患胃食管反流和新发 BE。相反，Roux-en-Y 胃旁路术与减少反流和潜在改善或解决 BE 相关。目前没有关于减肥手术后 BE 监测的指南。BE 是减肥手术患者管理中的一个重要考虑因素。需要循证建议来指导手术选择和术后监测。目前没有关于减肥手术后 BE 监测的指南。BE 是减肥手术患者管理中的一个重要考虑因素。需要循证建议来指导手术选择和术后监测。目前没有关于减肥手术后 BE 监测的指南。BE 是减肥手术患者管理中的一个重要考虑因素。需要循证建议来指导手术选择和术后监测。