Incidence of Biliary Reflux Esophagitis After Laparoscopic Omega Loop Gastric Bypass in Morbidly Obese Patients

J Laparoendosc Adv Surg Tech A. 2017 Jun;27(6):618-622. doi: 10.1089/lap.2016.0401. Epub 2017 Feb 3.


Background: Omega loop gastric bypass is a successful bariatric surgery with numerous favorable circumstances as being basic, effective on weight reduction and treatment of obesity associated metabolic disorder, the short expectation to learn and adapt, and the simplicity of correction and inversion. However, there are arguments about the possibility of biliary reflux and/or the potential danger of gastroesophageal malignancy after the procedure.

Methods: Fifty patients experiencing morbid obesity with body mass index >40 or >35 kg/m2 with two related comorbidities, for example, diabetes type II, hypertension, or dyslipidemia, underwent omega loop gastric bypass with a follow-up period up to 18 months, investigating for any symptom of reflux infection by upper gastrointestinal tract endoscopy and pH metry.

Results: Reflux esophagitis (a gastroesophageal reflux disease) was detected in 3 patients (6%); 2 cases (4%) showed (Grade A) acidic reflux esophagitis at 6 and 12 months postoperatively. Just 1 case (2%) had experienced gastroesophageal biliary reflux esophagitis (Grade A) at 12 months. No metaplasia or dysplasia was detected in the endoscopic biopsies.

Conclusion: Omega loop gastric bypass is a safe and effective bariatric procedure with low incidence of postoperative biliary reflux, metaplasia, or dysplasia at the esophagogastric junction, confirmed 18 months after the operation.

Keywords: bariatric surgery; biliary reflux; gastric bypass; mini-gastric bypass; reflux esophagitis.

MeSH terms

  • Adult
  • Body Mass Index
  • Egypt
  • Esophagitis, Peptic / etiology*
  • Female
  • Gastric Bypass / adverse effects*
  • Gastric Bypass / methods
  • Humans
  • Incidence
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / etiology
  • Treatment Outcome
  • Young Adult