Evaluation of reflux in the pre- and postoperative periods in patients undergoing mini (one-anastomosis) gastric bypass due to morbid obesity.

BACKGROUND

Obesity is a prevalent health problem in both developed and developing countries. There is no consensus on the incidence of gastro-oesophageal reflux following MGB, and the underlying factors affecting reflux remain unclear.

AIM: This study aimed to investigate factors that may influence the development of gastro-oesophageal and biliary reflux after MGB surgery.

METHODS

This study was designed as a retrospective cohort study. Patients aged 18-65 years who underwent MGB surgery were included in the study. Reflux symptoms were assessed using the GerdQ questionnaire preoperatively and at 6 months and 1 year postoperatively, and the results were compared.

RESULTS

A total of 256 patients were included in the study, with an average age of 44.51 ± 10.07 years. The mean preoperative body mass index (BMI) was 47.8 ± 8.32 kg/m², decreasing to 28.05 ± 5.44 kg/m² at the one-year postoperative mark. The proportion of patients experiencing severe reflux decreased significantly from 42.7% preoperatively to 7.8% at 1 year postoperatively (p < 0.001). However, reflux symptoms at six and twelve months postoperatively were significantly higher in patients with a preoperative hiatal hernia (p < 0.001).

CONCLUSION

Mini gastric bypass surgery is an effective option for managing reflux; however, as symptoms do not improve in patients with a preoperative hiatal hernia, this procedure should be avoided in patients with both gastro-oesophageal reflux and a hiatal hernia. Furthermore, the increased risk of biliary reflux should always be considered in patients with a hiatal hernia but without gastro-oesophageal reflux.