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- Title
Long-Term Evaluation of Biliary Reflux on Esogastric Mucosae after One-Anastomosis Gastric Bypass and Esojejunostomy in Rats.
- 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
- Abstract
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 < 0.001). Conclusions: After a 30-week follow-up period, OAGB/MGB rats did not develop any precancerous or cancerous lesions when more than 40% of EJ rats had intestinal metaplasia.
- Subjects
RATS; FUNDOPLICATION; MAGNETIC resonance imaging; GASTRIC bypass; INTESTINAL ischemia; PRECANCEROUS conditions; MORBID obesity
- Publication
Obesity Surgery, 2020, Vol 30, Issue 7, p2598
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-020-04521-4