Cirugía Bariátrica y Laparoscópica, Departamento de Cirugía General, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
Cir Esp (Engl Ed). 2023 Oct;101 Suppl 4:S63-S68. doi: 10.1016/j.cireng.2023.02.014. Epub 2023 Nov 16.
The growing epidemic of obesity and the increase in weight loss surgery has led to a resurgence of interest in biliary reflux because anatomical alterations may be refluxogenic. HIDA scan is the least invasive scan with good patient tolerability, sensitivity and reproducibility for the diagnosis of biliary reflux. Patients with more advanced oesophageal lesions have a higher degree of duodenal reflux. It has been shown in animal models and in vitro that there is more Barrett's and dysplasia with duodenal reflux. There are two cases of post-OAGB malignancy reported in 20 years, both without correlation with a biliary aetiology, so the carcinogenic risk probably remains theoretical. Prospective trials on OAGB should include endoscopy preoperatively and at 5-year intervals, to have data on the real effects of bile exposure on the gastric reservoir and oesophagus.
肥胖症的日益流行和减肥手术的增加导致人们对胆液反流重新产生兴趣，因为解剖结构的改变可能是反流性的。HIDA 扫描是诊断胆液反流最具侵袭性的扫描，具有良好的患者耐受性、敏感性和可重复性。食管病变更严重的患者十二指肠反流程度更高。动物模型和体外研究表明，十二指肠反流与更多的 Barrett 食管和发育不良有关。OAGB 后有两例恶性肿瘤报告，均与胆液病因无关，因此致癌风险可能仍属理论上的。OAGB 的前瞻性试验应包括术前和 5 年间隔的内镜检查，以获得胆汁暴露对胃储存器和食管的实际影响的数据。
