The Question of Bile Gastro-Esophageal Reflux
Although it was the main reason to abandon Mason’s loop gastric bypass, the mini-gastric bypass (MGB) anatomical configuration makes esophageal bile reflux highly implausible. However, controversy remains regarding the long-term theoretical risk of subsequent biliary reflux and its possible complications following MGB. According to the current literature, symptomatic gastric and/or esophageal bile reflux and reoperations after MGB due to “intractable” bile reflux are relatively rare.
In addition, cancer arising in the gastric pouch or esophagus has never been reported after specifically MGB, and the only case of cancer reported so far originated in the excluded stomach. However, since gastric/esophageal cancer may appear at least 20 years post-operatively, the fact that it has not been found after MGB may seem to be not enough evidence.
Clear definitions must be made in regard to symptoms, diagnostic approach, and medical treatment of bile reflux after MGB.
KeywordsMini-gastric bypass Mason loop gastric bypass Bile reflux gastritis Barrett’s esophagitis Gastric cancer Esophageal cancer Diagnosis Symptoms Conversion surgery
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