Incidence of Bile Reflux in One-Anastomosis Gastric Bypass (OAGB): Variability and Contributing Factors: A Review

Abstract

Background:

One Anastomosis Gastric Bypass (OAGB) has gained recognition as an effective bariatric procedure. However, bile reflux remains a debated complication, with varying reported incidence rates. This review aims to provide a comprehensive analysis of bile reflux after OAGB, exploring its incidence, diagnostic methods, influencing factors.

Methods:

A review of randomized controlled trials and cohort study was conducted, focusing on bile reflux after OAGB. The studies were identified through a thorough search of databases using keywords such as “bile reflux,” “OAGB,” and “bariatric surgery.” Diagnostic methods included hepatobiliary scintigraphy, endoscopy, and assessment of symptoms.

Results:

The incidence of bile reflux after OAGB ranged from 3.4% to 70%, influenced by diagnostic approaches and surgical techniques. Hepatobiliary scintigraphy and endoscopy were the primary diagnostic tools, with scintigraphy detecting bile reflux in up to 70% of patients with OAGB. Surgical modifications, such as adjusting the length of the biliopancreatic limb and incorporating anti-reflux stitches, significantly reduced the incidence of bile reflux. Comparative studies did not show significant differences in the incidence of bile reflux between OAGB and Roux-en-Y gastric bypass (RYGB).

Conclusion:

Bile reflux after OAGB is a measurable but often asymptomatic complication, manageable through surgical optimization and standardized diagnostic protocols. Long-term monitoring and further research are essential to refine surgical techniques and improve patient outcomes, ensuring that OAGB continues to be an option in metabolic and bariatric surgery.