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One-Anastomosis Gastric Bypass: Why Biliary Reflux Remains Controversial?

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Abstract

One-anastomosis gastric bypass is an alternative to the “gold-standard” Roux-en-Y gastric bypass. This technique appears to be safe and efficient, but controversy remains regarding the long-term theoretical risk of subsequent biliary reflux and its possible complications, such as cancer. The aim of the present narrative review was to summarize some of the current thoughts on biliary reflux. Research has established that exposure to chronic bile reflux in humans and rats (outside the “bariatric surgery” box) induce esophageal intestinal metaplasia and esophageal adenocarcinoma. Although one-anastomosis gastric bypass can theoretically induce chronic biliary reflux, the incidence of biliary reflux and risk of cancer have not been prospectively evaluated. Clarification of this controversial issue is urgently needed.

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References

  1. Czernichow S, Paita M, Nocca D, et al. Current challenges in providing bariatric surgery in France: a nationwide study. Medicine 2016. In press.

  2. Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11:276–80.

    Article  CAS  PubMed  Google Scholar 

  3. Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11:321–6.

    Article  PubMed  Google Scholar 

  4. Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25:951–8.

    Article  PubMed  Google Scholar 

  6. Champion G, Richter JE, Vaezi MF, et al. Duodenogastroesophageal reflux: relationship to pH and importance in Barrett’s esophagus. Gastroenterol. 1994;107:747–54.

    Article  CAS  Google Scholar 

  7. Sifrim D, Castell D, Dent J, et al. Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux. Gut. 2004;53:1024–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Tolone S, Cristiano S, Savarino E, et al. Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis. 2016;12:62–9.

    Article  PubMed  Google Scholar 

  9. Scozzari G, Trapani R, Toppino M, et al. Esophagogastric cancer after bariatric surgery : systematic review of the literature. Surg Obes Relat Dis. 2013;9:133–42.

    Article  PubMed  Google Scholar 

  10. Greene CL, Worrell SG, DeMeester TR. Rat reflux model of esophageal cancer and its implication in human disease. Ann Surg. 2015;262:910–24.

    Article  PubMed  Google Scholar 

  11. Bassily R, Smallwood RA, Crotty B. Risk of gastric cancer is not increased after partial gastrectomy. J Gastroenterol Hepatol. 2000;15:762–5.

    Article  CAS  PubMed  Google Scholar 

  12. Csendes A, Burgos AM, Smok G, et al. Latest results (12-21 years) of a prospective randomized study comparing Billroth II and Roux-en-Y anastomosis after a partial gastrectomy plus vagotomy in patients with duodenal ulcers. Ann Surg. 2009;249:189–94.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service de chirurgie digestive, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris cedex, France

    Matthieu Bruzzi & Jean-Marc Chevallier

  2. Université Paris Descartes, Paris, France

    Matthieu Bruzzi, Jean-Marc Chevallier & Sébastien Czernichow

  3. Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France

    Sébastien Czernichow

Authors
  1. Matthieu Bruzzi
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  2. Jean-Marc Chevallier
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  3. Sébastien Czernichow
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Correspondence to Matthieu Bruzzi.

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Bruzzi, M., Chevallier, JM. & Czernichow, S. One-Anastomosis Gastric Bypass: Why Biliary Reflux Remains Controversial?. OBES SURG 27, 545–547 (2017). https://doi.org/10.1007/s11695-016-2480-x

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  • DOI: https://doi.org/10.1007/s11695-016-2480-x

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