Suppr超能文献

胆囊切除术对单吻合口胃旁路术后胆汁反流的影响。

The Impact of Cholecystectomy on Bile Reflux After One Anastomosis Gastric Bypass.

作者信息

Farzadmanesh Mohammad Javad, Shahsavan Masoumeh, Shahmiri Shahab Shahabi, Ghorbani Mahsa, Fathi Mohammad, Mehrnia Nariman, Pazouki Abdolreza, Kermansaravi Mohammad

机构信息

Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.

Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran.

出版信息

Obes Surg. 2025 Jan;35(1):78-86. doi: 10.1007/s11695-024-07560-3. Epub 2024 Nov 27.

Abstract

BACKGROUND

Bile reflux (BR) is an issue after one anastomosis gastric bypass (OAGB). Cholecystectomy can increase BR in patients without a history of metabolic and bariatric surgery. We aimed to evaluate the effect of cholecystectomy on BR after OAGB.

METHODS

This prospective observational study was conducted between March 2017 and December 2022 including 34 matched adult individuals with a body mass index ≥ 40 kg/m or ≥ 35 in the presence of comorbidities and gallstone disease in preop evaluations who underwent primary OAGB including 17 patients who had undergone cholecystectomy simultaneously or after OAGB (OAGB + LC) and 17 patients without cholecystectomy (OAGB). All patients underwent evaluations for gastroesophageal reflux disease (GERD) and bile reflux (BR) using various methods including esophagogastroduodenoscopy (EGD), the GERD-Q questionnaire, and a hepatobiliary iminodiacetic acid (HIDA) scan.

RESULTS

Thirty-four patients were included in this study. BR into the esophagus was not detected in both groups. BR to the gastric pouch was observed in 4 patients (23.5%) of the OAGB group and 6 patients (35.3%) of the OAGB + LC group (P = 0.452). BR to gastric remnant was observed in 6 patients (one and five patients in OAGB and OAGB + LC groups respectively) (P = 0.072). There was no statistically significant difference between the two groups, although it was clinically significant.

CONCLUSION

Cholecystectomy after OAGB is not associated with a change in the rate of BR in the gastric pouch but increases the incidence of BR into gastric remnant that may be harmful in the long term.

摘要

背景

胆汁反流(BR)是单吻合口胃旁路术(OAGB)后的一个问题。胆囊切除术可增加无代谢和减重手术史患者的胆汁反流。我们旨在评估胆囊切除术对OAGB术后胆汁反流的影响。

方法

这项前瞻性观察性研究于2017年3月至2022年12月进行,纳入了34名匹配的成年个体,他们术前评估时体重指数≥40kg/m²或合并症及胆结石疾病存在时≥35kg/m²,接受了初次OAGB,其中17例患者在OAGB同时或之后接受了胆囊切除术(OAGB+LC),17例未接受胆囊切除术(OAGB)。所有患者使用包括食管胃十二指肠镜检查(EGD)、GERD-Q问卷和肝胆亚氨基二乙酸(HIDA)扫描等多种方法进行胃食管反流病(GERD)和胆汁反流(BR)评估。

结果

本研究共纳入34例患者。两组均未检测到食管胆汁反流。OAGB组有4例患者(23.5%)和OAGB+LC组有6例患者(35.3%)观察到胆汁反流至胃囊(P=0.452)。观察到6例患者胆汁反流至胃残端(OAGB组和OAGB+LC组分别为1例和5例)(P=0.072)。两组之间虽无统计学显著差异,但具有临床意义。

结论

OAGB术后胆囊切除术与胃囊胆汁反流率的变化无关,但会增加胆汁反流至胃残端的发生率,从长期来看可能有害。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验