Bile Gastritis Following Laparoscopic Single Anastomosis Gastric Bypass: Pilot Study to Assess Significance of Bilirubin Level in Gastric Aspirate

One anastomosis gastric bypass (OAGB)/mini gastric bypass is now considered to be a safe and efficient method for morbidly obese patients but has complications and adverse events such as other surgical procedures. The present paper outlines the need for and the nature of revisional surgery in the long-term following OAGB in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was carried out in PubMed. All articles on OAGB for which the authors described a patient needing revisional surgery in the long term after OAGB were examined.

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“…The incidence of post-OAGB GERD has been reported from 0% to 30% in different studies. [ 5 9 10 11 13 14 15 18 30 31 32 33 34 ]…”

Section: Resultsmentioning

confidence: 99%

Revisional surgery after one anastomosis/mini gastric bypass: A narrative review

Kermansaravi¹,

Mahawar²,

Jazi³

et al. 2020

J Res Med Sci

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“…MGB is a better alternative to Roux-en-Y gastric bypass (RYGB), as it has a shorter operative time, only one anastomosis, with rare incidence of internal herniation, shorter learning curve, easily reversed, with equivalent or even superior results in terms of weight loss [7][8][9][10]. Although biliary gastritis after MGB was discussed in many studies, yet the measuring of Bilirubin level in the pouch and its effect on the mucosa was mentioned only in the study done by shenouda et al, they reported that the rate of biliary gastritis after MGB reached 30%, and this is correlated with the level of bile in the pouch, Among 20 patients, the EBWL 6 months postoperatively was 74% (60-84), with no mortalities ,and one case of calf DVT 2 weeks after discharge [11]. In 2017, Carbajo reported in his study that follow up UGI endoscopy after 5 years revealed, mild to moderate pouch gastritis (8%), but there were no worrisome endoscopic or histological changes, mean operative time was 86 min (45-180).…”

Section: Discussionmentioning

confidence: 99%

Biliary reflux gastritis after Mini Gastric Bypass: The effect of Bilirubin level

Lasheen¹,

Mahfouz²,

Salama³

et al. 2019

Arch Surg Clin Res

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Background: Minigastric bypass is gaining popularity worldwide as an effective bariatric surgery which has fewer complications than RYGB. There is raising concerns about biliary refl ux and its effect on gastric mucosa. In this study we tried to fi nd the link between the presence of bile in the stomach and the incidence of gastritis after MGB. including 40 patients. All patients underwent MGB with a 12-month follow-up, UGI endoscopy was performed 9 months after MGB for all patients, where multiple biopsies and gastric aspirate were obtained for bilirubin level.Results: Mean age at operation was 32 years (18-60) and preoperative BMI 44.31 kg/m2. The mean operative time was 95 (± 18 min), Mean % EWL was 81.2% at 12 months. Complete resolution occurred of hypertension in 8 patients (80%) and of Diabetes type 2 in 11 patients (84.2%). Level of bilirubin in gastric aspirate was elevated in 8 patients (20%) all of them had different levels pouch gastritis confi rmed by histopathological examination. Conclusion:Biliary refl ux reached about 20% after MGB, the severity of biliary gastritis is related to the elevation of bilirubin level in the gastric aspirates, this results need to be confi rmed by further studies on the MGB.

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“…The long, narrow gastric pouch and widely patent gastrojejunostomy proposed as likely mechanistic explanations [ 22 ]. Studies by Lasheen and Shenouda reported post-operative gastroesophagitis in 32.5% of patients at 9 months and 55% at 6 months, respectively; however, no comment was made about whether these findings were de novo post-operative findings or had been present pre-operatively [ 14 , 15 ]. Our study showed no association between de novo gastroesophagitis and positive reflux on scintigraphy, contrasting with a positive association reported by Saarinen’s group [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery

et al. 2022

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Purpose Excellent metabolic improvement following one anastomosis gastric bypass (OAGB) remains compromised by the risk of esophageal bile reflux and theoretical carcinogenic potential. No ‘gold standard’ investigation exists for esophageal bile reflux, with diverse methods employed in the few studies evaluating it post-obesity surgery. As such, data on the incidence and severity of esophageal bile reflux is limited, with comparative studies lacking. This study aims to use specifically tailored biliary scintigraphy and upper gastrointestinal endoscopy protocols to evaluate esophageal bile reflux after OAGB, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Methods Fifty-eight participants underwent OAGB (20), SG (15) or RYGB (23) between November 2018 and July 2020. Pre-operative reflux symptom assessment and gastroscopy were performed and repeated post-operatively at 6 months along with biliary scintigraphy. Results Gastric reflux of bile was identified by biliary scintigraphy in 14 OAGB (70%), one RYGB (5%) and four SG participants (31%), with a mean of 2.9% (SD 1.5) reflux (% of total radioactivity). One participant (OAGB) demonstrated esophageal bile reflux. De novo macro- or microscopic gastroesophagitis occurred in 11 OAGB (58%), 8 SG (57%) and 7 RYGB (30%) participants. Thirteen participants had worsened reflux symptoms post-operatively (OAGB, 4; SG, 7; RYGB, 2). Scintigraphic esophageal bile reflux bore no statistical association with de novo gastroesophagitis or reflux symptoms. Conclusion Despite high incidence of gastric bile reflux post-OAGB, esophageal bile reflux is rare. With scarce literature of tumour development post-OAGB, frequent low-volume gastric bile reflux likely bears little clinical consequence; however, longer-term studies are needed. Clinical Trial Registry Australian New Zealand Clinical Trials Registry number ACTRN12618000806268. Graphical abstract

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Bile Gastritis Following Laparoscopic Single Anastomosis Gastric Bypass: Pilot Study to Assess Significance of Bilirubin Level in Gastric Aspirate

Cited by 25 publications

References 13 publications

Revisional surgery after one anastomosis/mini gastric bypass: A narrative review

Revisional surgery after one anastomosis/mini gastric bypass: A narrative review

Biliary reflux gastritis after Mini Gastric Bypass: The effect of Bilirubin level

Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery

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