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Observational Study
. 2025 Jan;35(1):78-86.
doi: 10.1007/s11695-024-07560-3. Epub 2024 Nov 27.

The Impact of Cholecystectomy on Bile Reflux After One Anastomosis Gastric Bypass

Mohammad Javad Farzadmanesh  1 , Masoumeh Shahsavan  1 , Shahab Shahabi Shahmiri  2   3 , Mahsa Ghorbani  4 , Mohammad Fathi  1 , Nariman Mehrnia  1 , Abdolreza Pazouki  2   3 , Mohammad Kermansaravi  5   6
Affiliations
Observational Study

The Impact of Cholecystectomy on Bile Reflux After One Anastomosis Gastric Bypass

Mohammad Javad Farzadmanesh et al. Obes Surg. 2025 Jan.

Abstract

Background: Bile reflux (BR) is an issue after one anastomosis gastric bypass (OAGB). Cholecystectomy can increase BR in patients without a history of metabolic and bariatric surgery. We aimed to evaluate the effect of cholecystectomy on BR after OAGB.

Methods: This prospective observational study was conducted between March 2017 and December 2022 including 34 matched adult individuals with a body mass index ≥ 40 kg/m2 or ≥ 35 in the presence of comorbidities and gallstone disease in preop evaluations who underwent primary OAGB including 17 patients who had undergone cholecystectomy simultaneously or after OAGB (OAGB + LC) and 17 patients without cholecystectomy (OAGB). All patients underwent evaluations for gastroesophageal reflux disease (GERD) and bile reflux (BR) using various methods including esophagogastroduodenoscopy (EGD), the GERD-Q questionnaire, and a hepatobiliary iminodiacetic acid (HIDA) scan.

Results: Thirty-four patients were included in this study. BR into the esophagus was not detected in both groups. BR to the gastric pouch was observed in 4 patients (23.5%) of the OAGB group and 6 patients (35.3%) of the OAGB + LC group (P = 0.452). BR to gastric remnant was observed in 6 patients (one and five patients in OAGB and OAGB + LC groups respectively) (P = 0.072). There was no statistically significant difference between the two groups, although it was clinically significant.

Conclusion: Cholecystectomy after OAGB is not associated with a change in the rate of BR in the gastric pouch but increases the incidence of BR into gastric remnant that may be harmful in the long term.

Keywords: Bile reflux; Cholecystectomy; HIDA scan; One anastomosis gastric bypass.

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Conflict of interest statement

Declarations. Informed Consent: Informed consent was obtained from the participants included in the consensus study. Competing Interests: The authors declare no competing interests.

References

    1. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg. 2021;31(5):1937–48. https://doi.org/10.1007/s11695-020-05207-7 . - DOI - PubMed - PMC
    1. Aprea G, Canfora A, Ferronetti A, et al. Morpho-functional gastric pre-and post-operative changes in elderly patients undergoing laparoscopic cholecystectomy for gallstone related disease. BMC Surg. 2012;12 Suppl 1:S5. https://doi.org/10.1186/1471-2482-12-s1-s5 . - DOI - PubMed
    1. Arnon-Sheleg E, Farraj M, Michael S, et al. Modified hepatobiliary scintigraphy for the diagnosis of bile reflux in one-anastomosis gastric bypass surgery: a prospective multicenter study. Obes Surg. 2023;33(7):1997–2004. https://doi.org/10.1007/s11695-023-06632-0 . - DOI - PubMed
    1. Braghetto I, Martinez G, Korn O, et al. Laparoscopic subtotal gastrectomy in morbid obese patients: a valid option to laparoscopic gastric bypass in particular circumstances (prospective study). Surg Today. 2018;48:558–65. - DOI - PubMed
    1. Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27:1153–67. - DOI - PubMed

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