Evaluation of esophageal pathology in a group of patients 2 years after one-anastomosis gastric bypass (OAGB) - Cohort study
Abstract
BACKGROUND
One-anastomosis gastric bypass (OAGB) is a well established surgical procedure for morbid obesity. There are ongoing speculations and a debate regarding biliary reflux (BR) following OAGB. Studies considered OAGB as a risk for symptomatic and asymptomatic BR and marginal ulceration. The aim of the study was to evaluate the rate of gastroesophageal reflux disease (GERD) and esophagitis in microscopic and macroscopic evaluations among post OAGB patients diagnosed by means of upper endoscopy (UE) with a mucosal biopsy, and to assess the influence of comorbidities and medical history on endoscopic findings.
METHODS
Patients operated between 1st January 2016 to 31st December 2017 were schedule, two years after OAGB for UE with a biopsy. In all cases, biopsies from the distal esophagus were obtained. All patients received a validated GERD-Health-Related Quality of Life questionnaire to assess their current symptoms.
RESULTS
Fifty patients were finally enrolled in the study. Twenty-four (48%) had grade A or B esophagitis. Four patients (8%) had endoscopically suspected esophageal metaplasia (ESEM). 34/50 (68%) patients had various histopathological esophageal changes, based on the conducted endoscopy, among which four cases of Barrett's esophagus were observed.
CONCLUSIONS
Despite the high rates of esophagitis in our cohort, most of the patients did not report any symptoms which confirm the thesis of the essential role of asymptomatic bile reflux following OAGB.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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