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.
Amar et al. (Tue,) studied this question.