Hill's categorization can be used to anticipate individuals who are at risk for postoperative GERD and EE following laparoscopic sleeve gastrectomy.

A single institution retrospective cohort study was conducted to investigate effects of several preoperative clinical and endoscopic traits on emergence of postoperative erosive esophagitis (EE) and gastroesophageal reflux disease (GERD).

All subjects who underwent laparoscopic sleeve gastrectomy (LSG) were included. To find preoperative factors that were substantially related to the emergence of postoperative GERD and EE, at up to one-year follow-up, univariate and multivariate analyses were conducted.

Only Hill's categorization of gastroesophageal junction and preoperative endoscopic presence of hiatal hernia detected on axial length were substantially related to emergence of postoperative GERD among 127 patients at up to one-year follow-up. Hill's categorization and hiatal hernia presence were also linked to postoperative EE at 1-year follow-up endoscopy.

Hill's II patients had a higher risk of developing postsurgery GERD (Odds Ratio [OR] 7.13) when compared to patients who had a Hill's I flap valve, and Hill's III patients had a higher risk of developing both EE (OR 34.49) and postsurgery GERD (OR 20.84). In this research, postoperative GERD and EE occurred in all patients with Hill's IV.

Following LSG, postoperative GERD and EE continue to be significant limitations. Hence, Hill's categorization was beneficial to predict postoperative GERD and EE development.