Revisional Bariatric Surgery After Roux-en-Y Gastric Bypass for Bile Reflux: a Single-Center Long-Term Cohort Study

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Outcomes

Background:

• Bile reflux is a complication following Roux-en-Y gastric bypass (RYGB).
• Revisional bariatric surgery (RBS) is indicated for managing specific RYGB complications like bile reflux.
• Literature on long-term outcomes of RBS for bile reflux post-RYGB is limited.

Purpose of the Study:

• To evaluate the 10-year outcomes of revisional bariatric surgery (RBS) for managing bile reflux after primary Roux-en-Y gastric bypass (RYGB).

Main Methods:

• A retrospective, single-center study included patients who underwent RYGB complicated by bile reflux and subsequently had RBS.
• Patients were categorized into two groups based on the cause of bile reflux.
• Surgical outcomes and nutritional status were assessed and compared between groups over a 10-year follow-up period.

Main Results:

• The study included 41 patients (90.2% female, 97.6% white).
• Roux limb lengthening (56.1%) and gastrogastric fistula takedown (43.9%) showed no significant differences in complications, blood loss, or hospital stay.
• Long-term resolution of obesity comorbidities was observed, with no reported mortality, bile reflux recurrence, or nutrient deficiencies over 10 years.

Conclusions:

• Revisional bariatric surgery (RBS) after Roux-en-Y gastric bypass (RYGB) for bile reflux is safe and effective, yielding positive short- and long-term results.
• No bile reflux recurrence or mortality was observed in the study cohort.
• Continued patient monitoring and adequate nutritional supplementation are crucial for minimizing risks associated with RBS.