Bile Reflux Scintigraphy After Mini-Gastric Bypass

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http://hdl.handle.net/10138/238192

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Saarinen , T , Räsänen , J V , Salo , J , Loimaala , A , Pitkonen , M , Leivonen , M & Juuti , A 2017 , ' Bile Reflux Scintigraphy After Mini-Gastric Bypass ' , Obesity Surgery , vol. 27 , no. 8 , pp. 2083-2089 . https://doi.org/10.1007/s11695-017-2608-7

Title: Bile Reflux Scintigraphy After Mini-Gastric Bypass
Author: Saarinen, Tuure; Räsänen, Jari Veli; Salo, Jarmo; Loimaala, Antti; Pitkonen, Miia; Leivonen, Marja; Juuti, Anne
Other contributor: University of Helsinki, Clinicum
University of Helsinki, III kirurgian klinikka
University of Helsinki, Clinicum
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Physics
University of Helsinki, II kirurgian klinikka









Date: 2017-08
Language: eng
Number of pages: 7
Belongs to series: Obesity Surgery
ISSN: 0960-8923
DOI: https://doi.org/10.1007/s11695-017-2608-7
URI: http://hdl.handle.net/10138/238192
Abstract: Significant weight-loss and diabetes remission have been reported after mini-gastric bypass (MGB). Concern has been raised regarding postoperative bile reflux (BR), but it has not been demonstrated in previous studies. We set out to find out if BR is evident in hepatobiliary scintigraphy after MGB. Nine consecutive patients, seven with type 2 diabetes, underwent MGB (15 cm gastric tube, 250-275 cm biliary limb) at our institution with a 12-month follow-up, with none lost to follow-up. Then, 10.7 months (8.6-13.0) after MGB, all patients underwent hepatobiliary scintigraphy and a reflux symptom questionnaire (GerdQ) was filled out. A gastroscopy with biopsies was done for all patients with a bile-reflux-positive scintigraphy. Mean age at operation was 56 years (41-65) and preoperative BMI 43.1 kg/m(2) (34.2-54.6). Mean %EWL was 83.9 (49.5-128.3) at 12 months. Four patients reached diabetes remission and two became insulin-independent. Hepatobiliary scintigraphy showed a transient BR into the gastric tube for five patients. Bile tracer was found in the gastric tube at 23-58 min after the tracer injection and highest activity was 8% (1-8%) at 58 min. Bile tracer was not found in the esophagus of any of the patients. One patient with a positive scintigraphy in the gastric tube required re-operation. Two patients with reflux symptoms had a negative scintigraphy. Our results indicate that transient bile reflux is common after MGB in the gastric tube, but not in the esophagus. The clinical relevance of bile reflux needs further studies.
Subject: Mini-gastric bypass
Single-anastomosis gastric bypass
Bariatric surgery
Bile reflux
Scintigraphy
ROUX-EN-Y
MORBID-OBESITY
INTESTINAL METAPLASIA
ENTEROGASTRIC REFLUX
BARRETTS-ESOPHAGUS
DISEASE
SURGERY
COMPLICATIONS
EXPERIENCE
CARCINOMA
3126 Surgery, anesthesiology, intensive care, radiology
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