Long-term consequences of one anastomosis gastric bypass on esogastric mucosa in a preclinical rat model

Sci Rep. 2020 Apr 30;10(1):7393. doi: 10.1038/s41598-020-64425-2.

Abstract

Although bariatric surgery is proven to sustain weight loss in morbidly obese patients, long-term adverse effects have yet to be fully characterized. This study compared the long-term consequences of two common forms of bariatric surgery: one-anastomosis gastric bypass (OAGB) and Roux-en-Y Gastric Bypass (RYGB) in a preclinical rat model. We evaluated the influence of biliopancreatic limb (BPL) length, malabsorption, and bile acid (BA) reflux on esogastric mucosa. After 30 weeks of follow-up, Wistar rats operated on RYGB, OAGB with a short BPL (15 cm, OAGB-15), or a long BPL (35 cm, OAGB-35), and unoperated rats exhibit no cases of esogastric cancer, metaplasia, dysplasia, or Barrett's esophagus. Compared to RYGB, OAGB-35 rats presented higher rate of esophagitis, fundic gastritis and perianastomotic foveolar hyperplasia. OAGB-35 rats also revealed the greatest weight loss and malabsorption. On the contrary, BA concentrations were the highest in the residual gastric pouch of OAGB-15 rats. Yet, no association could be established between the esogastric lesions and malabsorption, weight loss, or gastric bile acid concentrations. In conclusion, RYGB results in a better long-term outcome than OAGB, as chronic signs of biliary reflux or reactional gastritis were reported post-OAGB even after reducing the BPL length in a preclinical rat model.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bile Reflux* / etiology
  • Bile Reflux* / metabolism
  • Bile Reflux* / pathology
  • Bile Reflux* / physiopathology
  • Chronic Disease
  • Esophageal Mucosa* / metabolism
  • Esophageal Mucosa* / pathology
  • Esophageal Mucosa* / physiopathology
  • Esophagitis* / etiology
  • Esophagitis* / metabolism
  • Esophagitis* / pathology
  • Esophagitis* / physiopathology
  • Gastric Bypass / adverse effects*
  • Gastric Mucosa* / metabolism
  • Gastric Mucosa* / pathology
  • Gastric Mucosa* / physiopathology
  • Hyperplasia / etiology
  • Hyperplasia / metabolism
  • Hyperplasia / pathology
  • Hyperplasia / physiopathology
  • Models, Biological*
  • Obesity, Morbid* / metabolism
  • Obesity, Morbid* / pathology
  • Obesity, Morbid* / physiopathology
  • Obesity, Morbid* / surgery
  • Postoperative Complications* / metabolism
  • Postoperative Complications* / pathology
  • Postoperative Complications* / physiopathology
  • Rats
  • Rats, Wistar