Bile reflux after laparoscopic mini / one anastomosis gastric bypass: the problem and prevention



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Abstract

Laparoscopic mini-gastric bypass (LMGB) is currently one of the three most common bariatric surgical operations. One of the reasons for reoperations after LMGB is pathological bile reflux, which, in addition to a noticeable decrease in the quality of life of patients, poses a potential threat to the development of neoplastic processes in the stomach and esophagus. The purpose of the study was to systematize and analyze modern literature information on terminology, diagnosis and frequency of detection, pathophysiological significance and methods of preventing bile reflux after LMGB. An analysis of Russian and English full-text literature sources on the problem of bile reflux after LMGB in the bibliographic databases of the Russian Science Citation Index, PubMed, Google Scholar, ScienceDirect was performed. The frequency of diagnosing bile reflux after LMGB varies from 2 to 57.9% depending on the instrumental diagnostic methods used: flexible endoscopy, 24-hour pH impedance measurements, spectrophotometry of bilirubin in refluxate, hepatobiliary scintigraphy. The pathogenetic effect of the contents of the small intestine on the mucous membrane of the stomach and esophagus after LMGB is mainly realized due to the direct cytotoxic and receptor-mediated effects of bile acids. The safety of the main stages of LMGB (creation of a gastric pouch and formation of a single anastomosis) is currently being reviewed from the standpoint of minimizing the risk of developing bile reflux. In addition, new techniques have been proposed to reduce the likelihood of intestinal contents entering the stomach and esophagus, but their effectiveness remains controversial.

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About the authors

Yurii S. Vinnik

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: yuvinnik@ya.ru
ORCID iD: 0000-0002-8995-2862
SPIN-code: 5070-8140
Russian Federation

Aleksandr A. Chaykin

Clinical hospital «RZD-Medicine» city Krasnoyarsk

Email: chaiki@inbox.ru
ORCID iD: 0009-0009-0994-081X

Dmitriy A. Chaykin

Clinical hospital «RZD-Medicine» city Krasnoyarsk

Email: conte4@yandex.ru
ORCID iD: 0000-0003-0098-1761
SPIN-code: 4098-5263

Olga Teplyakova

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Author for correspondence.
Email: teplyakova-olga@ya.ru
ORCID iD: 0000-0003-0005-3316
SPIN-code: 4975-0569
Scopus Author ID: 57627507000
ResearcherId: M-7060-2014

Professor,  Professor, General Surgery Department named after Professor M. I. Gulman

Russian Federation

Margarita Yu. Yureva

Email: hizhnenko2009@ya.ru
ORCID iD: 0009-0005-9185-278X
SPIN-code: 4551-1020

Nina V. Boyakova

Email: n79039248058@gmail.com
ORCID iD: 0000-0002-1761-4717

Dmitrii S. Vlasenko

Email: vdima2002@ya.ru
ORCID iD: 0009-0008-8550-5361

Valentina A. Bakhshyan

Email: v.a.bahshyan@gmail.com
ORCID iD: 0009-0000-5454-9961
SPIN-code: 6989-5951

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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