Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;30(11):4391-4400.
doi: 10.1007/s11695-020-04805-9. Epub 2020 Jul 3.

Postoperative Clinical-Endoscopic Follow-up for GERD and Gastritis After One Anastomosis Gastric Bypass for Morbid Obesity: How, When, and Why

Affiliations

Postoperative Clinical-Endoscopic Follow-up for GERD and Gastritis After One Anastomosis Gastric Bypass for Morbid Obesity: How, When, and Why

Francesco Pizza et al. Obes Surg. 2020 Nov.

Abstract

Introduction: The one anastomosis gastric bypass (OAGB) is a widely diffused surgical procedure for morbid obesity. Several studies considered OAGB at risk for biliary reflux and anastomotic ulcers. The aim of the study was to evaluate gastro-esophageal reflux disease (GERD) and esophagitis/gastritis rate after OAGB diagnosed by upper endoscopy (UE), comparing the results with GERD-Health-Related Quality of Life (HRQL) score.

Methods: From July 2014 to February 2019, patients underwent OAGB with at least 12-month follow-up were retrospectively evaluated. Clinical evaluation was associated with GERD-HRQL scoring. UE with a mucosal biopsy was also performed. A comparison among clinical scores and endoscopic findings was performed.

Results: Two hundred forty-one patients were analyzed in the study. Anthropometric features (BMI, %Excess weight loss, %Total weight loss) were significantly improved. Only 30% of patients with GERD-HQRL>30 showed esophagitis at UE: 11/181 (6.1%) showed grade A erosive esophagitis, 2/181 (1.1%) grade B esophagitis, whereas no patient resulted in grade C/D. Fifty-two patients (28.7%) showed endoscopic remnant gastritis of at least grade 1, with histological gastritis of at least mild grade in 70/181 patients (38.7%).

Conclusion: OAGB is a feasible and effective procedure in terms of weight reduction and comorbidities control, but controversies remain about the long-term onset of GERD and bile reflux. The incidence of esophagitis was increased after OAGB. However, the severity and incidence were lower compared to sleeve gastrectomy. Conversely, the incidence of gastritis, ileo-gastric anastomotic inflammation, and HP positivity were not negligible, suggesting the potential benefits of endoscopic surveillance after OAGB.

Keywords: Esophagitis; GERD; Gastritis; Obesity surgery; One anastomosis gastric bypass.

PubMed Disclaimer

References

    1. Fisher BL, Buchwald H, Clark W, et al. Mini-gastric bypass controversy. Obes Surg. 2001;11(6):773–7. - PubMed
    1. Musella M, Susa A, Manno E, et al. Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg. 2017;27(11):2956–67. - DOI
    1. Bruzzi M, Duboc H, Gronnier C, et al. Long-term evaluation of biliary reflux after experimental one-anastomosis gastric bypass in rats. Obes Surg. 2017;27(4):1119–22. - DOI
    1. Mahawar KK, Borg CM, Kular KS, et al. Understanding objections to one anastomosis (mini) gastricbypass: a survey of 417 surgeons not performing this procedure. Obes Surg. 2017;27:2222–8. - DOI
    1. Ramos AC, Chevallier JM, Mahawar K, et al. IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) consensus conference statement on one-anastomosis gastric bypass (OAGB-MGB): results of a modified Delphi study. Obes Surg. 2020;30(5):1625–34. - DOI