A systematic review and meta-analysis on GERD after OAGB: rate, treatments, and success

ABSTRACT

Introduction

This review aims to investigate the gastroesophageal reflux disease (GERD) as one of the important concerns for both surgeons and patients after one anastomosis gastric bypass (OAGB).

Method

PubMed, Scopus, Embase, Web of Science, and Cochrane were reviewed by the end of the 2021 with keywords relating to GERD, OAGB, and their equivalents. Data regarding OAGB, number of patients with GERD, treatment for GERD, endoscopy findings, the interval between GERD and OAGB were retrieved by two independent investigators. The primary effect/effect size measure was prevalence.

Results

40 studies examining 17,299 patients were included revealing that 2% of patients experience GERD following OAGB. Reflux after revisional OAGB is six times higher than primary OAGB. Despite being unclear, medical and surgical treatments for GERD after OAGB were used in 60% and 41% of patients with estimated success rate of 85% and 100%, respectively.

Conclusion

Based on how GERD was identified after OAGB, its rate ranged from 0 to 55%; the pooled rate of 2% is near to Roux-en-Y gastric bypass. GERD symptoms can be mild to be tolerated without medical treatment, moderate that respond to acid-reducing agents, or severe enough that are categorized as interactable and would need a surgical intervention.

KEYWORDS:

• Gastroesophageal reflux
• gastric bypass
• bariatric surgery
• bile reflux
• one-anastomosis gastric bypass

Article highlights

• Risk of reflux after one anastomosis gastric bypass is 2%, which is near to Roux-en-Y gastric bypass

• one anastomosis gastric bypass as revisional approach has near six times higher risk of developing reflux

• before jump into surgery, medical treatment should be tested for reflux after one anastomosis gastric bypass

• Insidious intractable reflux after one anastomosis gastric bypass can be treated by surgery

• Conversion to Roux-en Y gastric bypass or addition of an enteroenterostomy solves severe reflux after one anastomosis gastric bypass

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

We express our gratitude toward Mr. Amirsalar Moazzensafaei for his kind support and technical notes.

Additional information

Funding

This paper was not funded.