Bile Reflux Scintigraphy After Mini-Gastric Bypass

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Hepatobiliary Imaging

Background:

• Mini-gastric bypass (MGB) is associated with significant weight loss and diabetes remission.
• Concerns exist regarding postoperative bile reflux (BR) after MGB, but it remains under-investigated.
• This study aimed to assess the incidence of BR following MGB using hepatobiliary scintigraphy.

Purpose of the Study:

• To investigate the presence and characteristics of bile reflux (BR) after mini-gastric bypass (MGB).
• To correlate hepatobiliary scintigraphy findings with reflux symptoms.
• To evaluate the need for further investigation in patients experiencing BR post-MGB.

Main Methods:

• Nine patients underwent MGB with a 12-month follow-up.
• Hepatobiliary scintigraphy and a reflux symptom questionnaire (GerdQ) were performed post-MGB.
• Gastroscopy with biopsies was conducted for patients with positive scintigraphy findings.

Main Results:

• Hepatobiliary scintigraphy revealed transient BR into the gastric tube in five patients (55.6%).
• Bile tracer was detected in the gastric tube between 23-58 minutes post-injection, with a maximum activity of 8%.
• No patients exhibited BR into the esophagus; one patient with BR required re-operation.

Conclusions:

• Transient bile reflux into the gastric tube is a common finding after MGB.
• Bile reflux into the esophagus was not observed in this cohort.
• The clinical significance of post-MGB bile reflux warrants further investigation.