Long-Term Evaluation of Biliary Reflux on Esogastric Mucosae after One-Anastomosis Gastric Bypass and Esojejunostomy in Rats

Background One-anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) remains controversial because it may cause chronic biliary reflux (BR). The risk of developing esogastric cancer due to BR after OAGB/MGB is based on the results of experimental rat studies using esojejunostomy (EJ). The aim of...

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Bibliographic Details
Published in:Obesity surgery 2020-07, Vol.30 (7), p.2598-2605
Main Authors: M’Harzi, Leïla, Chevallier, Jean-Marc, Certain, Anais, Autret, Gwennhaël, Levenson, Guillaume, Louis, David, Poghosyan, Tigran, Berger, Arthur, Rahmi, Gabriel, Broudin, Chloé, Clément, Olivier, Douard, Richard, Tavitian, Bertrand, Bruzzi, Matthieu
Format: Article
Language:English
Subjects:
Animals
Bile Reflux
Gastric Bypass - adverse effects
Gastrointestinal surgery
Magnetic resonance imaging
Medicine
Medicine & Public Health
Obesity, Morbid - surgery
Original Contributions
Rats
Rats, Wistar
Rodents
Surgery
Weight Loss
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Summary:Background One-anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) remains controversial because it may cause chronic biliary reflux (BR). The risk of developing esogastric cancer due to BR after OAGB/MGB is based on the results of experimental rat studies using esojejunostomy (EJ). The aim of this study was to analyze the potential long-term consequences of BR on the esogastric mucosae in OAGB/MGB-operated rats and to compare these results to those from the use of EJ. Methods Wistar rats received OAGB/MGB ( n  = 16), EJ ( n  = 16), and sham ( n  = 8) operations. Mortality and weight changes were evaluated throughout the experiment. BR was measured using magnetic resonance imaging (MRI). Rats received follow-ups for 30 weeks. A double-blinded histological analysis was performed in the esogastric segments. Results BR was diagnosed in OAGB/MGB and EJ rats using the MRI technique; no BR occurred in the sham group. After a 30-week follow-up, no incidences of dysplasia or cancer were observed in the three groups. Additionally, esophageal intestinal metaplasia and mucosal ulcerations were observed in 41.7% and 50% of EJ rats, respectively, and no incidences of these conditions were observed in OAGB/MGB and sham rats. The incidence of esophagitis was significantly higher and more severe in the EJ group compared to those in the OAGB/MGB and sham groups (EJ = 100%, OAGB/MGB = 16.7%, sham = 8.3%; p  
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-020-04521-4