Pathological and Histological Aspects of Biliary Reflux After Mini-Gastric Bypass

2021 ◽  
Author(s):  
Alexander G. Khitaryan ◽  
Arut V. Mezhunts ◽  
Olesya B. Starzhinskaya ◽  
Alexey A. Orekhov ◽  
Olga V. Voronova ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Mini Gastric Bypass ◽  
Biliary Reflux

scholarly journals Biliary reflux after laparoscopic modified antireflux monoanastomotic gastric bypass surgery

Pathologia ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. 311-320
Author(s):  
M. V. Nikolaiev
Keyword(s):  
Morbid Obesity ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Clinical Manifestations ◽  
Main Group ◽  
Mini Gastric Bypass ◽  
Control Group ◽  
Biliary Reflux ◽  
Gastric Bypass Operation

Aim. Determination of biliary reflux in patients with morbid obesity after a single-anastomotic gastric bypass operation performed in the clinic's modification and according to the classical Roux-en-Y gastric bypass technique. Development of diagnostic criteria for biliary reflux Materials and methods. The results of treatment of 36 patients with morbid obesity who underwent bypass surgery were studied. The patients are divided into two groups. Clinically modified laparoscopic monoanastomotic gastric bypass surgery was performed in 25 patients (main group). The control group included 11 patients after the standard technique of Roux-en-Y laparoscopic gastric bypass. Inclusion criteria were: persons of both sexes aged 18-60 years with morbid obesity and a body mass index of 40 or more, as well as 35 or more in the presence of comorbid diseases (type 2 diabetes mellitus, arterial hypertension, dyslipidemia, sleep apnea syndrome). In both groups, impedance pH measurements were performed in the postoperative period. Statistical processing was performed using the Statistica 13.0 software package using parametric and nonparametric statistical methods.  Results: Clinical manifestations of the enterogastric biliary reflex were found in both groups; in addition, clinical manifestations of the corresponding symptoms were noted by patients of both groups. The analysis of daily pH-metry in the studied groups showed that in the esophagus the time with pH <4 in the main group 2.83 (1.55; 3.95)% 3.00 (2.30; 3.50)% in the control group, time with pH 4-6.9 (physiological for the esophagus) 92.40 (90.65; 94.20)% and 94.10 (89.80; 95.50)%, respectively, time with pH> 7 (weak alkaline) was 4.80 (3.45; 5.85)% and in the control group 2.90 (1.20; 7.20)%. There was no statistically significant difference in these indicators (p> 0.05). Conclusions. Monoanastomotic gastric bypass surgery in the modification of the clinic has the same positive properties as the Rouen-Wye technique, allowing you to avoid the risks associated with possible pathological reflux of bile into the esophagus. Patients who have undergone mini-gastric bypass surgery require a thorough examination with fibrogastroscopy in combination with pH impedance measurement at least 1 time per year in order to determine biliary reflux and morphological changes both in the lumen of the esophagus and in the stomach stump. The level of quality of life of patients after surgery in the control group and the main group does not significantly differ, as evidenced by the results of the questionnaire survey using the GERG Q questionnaire, which indicates the effectiveness of the methodology of laparoscopic monoanastomotic gastric bypass surgery modified in the clinic. Key words: morbid obesity, gastric bypass surgery, surgical treatment, mini-gastric bypass, biliary reflux.

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

2019 ◽  
Vol 3 (1) ◽  
pp. 027-031
Author(s):  
Mohamed Lasheen ◽  
Mohamed Mahfouz ◽  
Tamer Salama* ◽  
Hossam El-Deen M Salem
Keyword(s):  
Gastric Bypass ◽  
Bilirubin Level ◽  
Mini Gastric Bypass ◽  
Reflux Gastritis ◽  
Biliary Reflux

scholarly journals PATHOMORPHOLOGICAL ASPECTS OF THE DEVELOPMENT OF BILIARY REFLUX AFTER MINI-GASTRIC BYPASS

2019 ◽  
Vol 178 (5) ◽  
pp. 22-30
Author(s):  
A. G. Khitaryan ◽  
A. E. Neimark ◽  
A. V. Mezhunts ◽  
O. B. Starzhinskaya ◽  
A. A. Orekhov ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Bile Reflux ◽  
Screening Method ◽  
Operation Time ◽  
Mini Gastric Bypass ◽  
Control Group ◽  
Study Group ◽  
Results Of Treatment ◽  
Biliary Reflux ◽  
The Difference

INTRODUCTION. MGB is considered to be the best alternative to Roux-en-Y gastric bypass (RYGB) due to the shorter operation time and fewer possible complications. The OBJECTIVE of this study was to determine biliary reflux in patients undergoing MGB with a hand-sewn gastroenteroanastomosis, and MGB with a stapler gastroenteroanastomosis.MATERIAL AND METHODS. This study included the analysis of results of treatment of 122 patients with morbid obesity and metabolic syndrome who had undergone laparoscopic MGB. Patients were divided into two clinical groups depending on the method of applying gastroenteroanastomosis. Clinical and endoscopic assessment was used to determine bile reflux; biliary reflux index (BRI) was used. In the postoperative period, the possibility of developing biliary reflux using fibrogastroscopy with biopsy of the gastric mucosa, microscopy of biopsy materials was evaluated. Microscopy of biopsy specimens was performed by a pathologist who evaluated each sample of gastric tissue in accordance with the system for determining the biliary reflux index (BRI).RESULTS. During fibrogastroscopy, biliary reflux was diagnosed in 9 (15.5 %) cases in the study group and 16 (26.6 %) cases in the control group. In the study group of patients, biliary reflux index (BRI) > 14 was determined in 3 patients (5.153 %). In the control group of patients, BRI> 14 was in 7 cases (10.94 %). The difference was significant (p<0.05).CONCLUSION. Determination of BRI index in patients undergoing MGB could be used as a screening method for diagnosing the biliary reflux in order to prevent and develop the tactic for further management of patients from a risk group of complications associated with the toxic effects of an aggressive bile refluxate.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

scholarly journals Applying an Anti-reflux Suture in the One Anastomosis Gastric Bypass to Prevent Biliary Reflux: a Long-Term Observational Study

2021 ◽  
Author(s):  
Nienke Slagter ◽  
Jonne Hopman ◽  
Anna G. Altenburg ◽  
Loek J. M. de Heide ◽  
Ewoud H. Jutte ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Observational Study ◽  
One Anastomosis Gastric Bypass ◽  
Biliary Reflux ◽  
The One

scholarly journals Mini-Gastric Bypass to Control Morbid Obesity and Diabetes Mellitus: What Radiologists Need to Know

2015 ◽  
Vol 16 (2) ◽  
pp. 325 ◽  
Author(s):  
Hyun Jeong Park ◽  
Seong Sook Hong ◽  
Jiyoung Hwang ◽  
Kyung Yul Hur
Keyword(s):  
Diabetes Mellitus ◽  
Morbid Obesity ◽  
Gastric Bypass ◽  
Mini Gastric Bypass ◽  
Obesity And Diabetes

Mini-Gastric Bypass by Mini-Laparotomy: A Cost-Effective Alternative in the Laparoscopic Era

2007 ◽  
Vol 17 (11) ◽  
pp. 1482-1486 ◽  
Author(s):  
Roger Noun ◽  
Eddy Riachi ◽  
Smart Zeidan ◽  
Bassam Abboud ◽  
Viviane Chalhoub ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Cost Effective ◽  
Effective Alternative ◽  
Mini Gastric Bypass ◽  
Cost Effective Alternative ◽  
Mini Laparotomy
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