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Volume 8 Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X Bariatric Surgery 2018 & Gastro 2018
March 15-16, 2018
JOINT EVENT
12th Global Gastroenterologists Meeting
3rd International Conference on Metabolic and Bariatric Surgery
&
March 15-16, 2018 Barcelona, Spain
Bile reflux of the remnant stomach following Roux-en-Y gastric bypass: An etiology of chronic abdominal
pain treated with remnant gastrectomy
Erika La Vella
University of Idaho, USA
Background: Bile reflux gastritis of the remnant stomach following Roux-en-Y gastric bypass (RYGB) causing chronic abdominal pain
has not been reported. We report a series of symptomatic patients with remnant gastritis treated effectively with remnant gastrectomy.
Objective: To report our experience with bile reflux remnant gastritis after RYGB and our outcomes following remnant gastrectomy.
Setting: Community teaching hospital.
Methods: All patients undergoing remnant gastrectomy were retrospectively reviewed for presenting symptoms, diagnostic workup,
pathology, complications, and symptom resolution.
Results: Nineteen patients underwent remnant gastrectomy for bile reflux gastritis at a mean of 4.4 years (52.3 months, range 8.5-
124 months) after RYGB. All patients were female and presented with pain, primarily epigastric 18/19 (95%), and described as
burning 11/19 (58%), with 10/19 (53%) reporting nausea. Endoscopy was performed preoperatively on all patients with successful
remnant inspection in 13 (68%), using push endoscopy (n=10) or operative assist (n=3) with 12/13 (92%) biopsy-positive for reactive
gastropathy. Seventeen (90%) completed a HIDA scan with 100% positivity demonstrating bile reflux across the pylorus. Surgical
approach was laparoscopic or robotic in 18 (95%) with hospital LOS of 2.7 days (range 0 to 12 d) with no major complications or
readmissions. Pathology of the remnant confirmed reactive gastropathy in 90% (n=17). 90% (N=17) of patients reported sustained
symptom resolution and 11% (n=2) of patients remained symptomatic at last follow up. We followed all patients for a mean of 6.6
years (1-194 months).
Conclusion: Bile reflux gastritis of the remnant stomach is a new consideration for chronic abdominal pain months to years following
RYGB. HIDA imaging and endoscopic biopsy are highly suggestive. Remnant gastrectomy is safe and effective treatment.
Recent Publications
1. La Vella Erika and Yarbrough Don (2014) Biliary Dyskinesia: A standardized approach. Western States Medical Monographs,
1(1):1-10.
Biography
Erika La Vella completed her Doctorate of Osteopathic Medicine at Pacific Northwest University and her residency training at Good Samaritan Regional Medical
Center in Corvallis, Oregon. She earned her Bachelor degree of Science in Nutrition from the University of Idaho. She has two publications and serves as an
Editorial Board Member of the Journal of Surgery and Research. She now practices as a Robotic General and Bariatric Surgeon at a community hospital in
Corvallis, Oregon. She has always appreciated the direct relationship that food quality, digestion and lifestyle have on human health. She believes that when
individuals are healthy, their families and communities around them begin to thrive.
Erika La Vella, J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C1-064