Incidence of Biliary Reflux Esophagitis After Laparoscopic Omega Loop Gastric Bypass in Morbidly Obese Patients.
BACKGROUND
Omega loop gastric bypass is a successful bariatric surgery with numerous favorable circumstances as being basic, effective on weight reduction and treatment of obesity associated metabolic disorder, the short expectation to learn and adapt, and the simplicity of correction and inversion. However, there are arguments about the possibility of biliary reflux and/or the potential danger of gastroesophageal malignancy after the procedure.


METHODS
Fifty patients experiencing morbid obesity with body mass index >40 or >35 kg/m2with two related comorbidities, for example, diabetes type II, hypertension, or dyslipidemia, underwent omega loop gastric bypass with a follow-up period up to 18 months, investigating for any symptom of reflux infection by upper gastrointestinal tract endoscopy and pH metry.


RESULTS
Reflux esophagitis (a gastroesophageal reflux disease) was detected in 3 patients (6%); 2 cases (4%) showed (Grade A) acidic reflux esophagitis at 6 and 12 months postoperatively. Just 1 case (2%) had experienced gastroesophageal biliary reflux esophagitis (Grade A) at 12 months. No metaplasia or dysplasia was detected in the endoscopic biopsies.


CONCLUSIONS
Omega loop gastric bypass is a safe and effective bariatric procedure with low incidence of postoperative biliary reflux, metaplasia, or dysplasia at the esophagogastric junction, confirmed 18 months after the operation.
Department of General Surgery, Faculty of Medicine, Ain Shams University , Cairo, Egypt .
Tamer M Said
TMS
Salama
Department of General Surgery, Faculty of Medicine, Ain Shams University , Cairo, Egypt .
Mohamed Ibrahim
MI
Hassan
D000328:Adult; D015992:Body Mass Index; D004534:Egypt; D004942:Esophagitis, Peptic / Q000209:etiology*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
bariatric surgery; biliary reflux; gastric bypass; mini-gastric bypass; reflux esophagitis