Bile reflux gastropathy: Prevalence and risk factors after therapeutic biliary interventions: A retrospective cohort study

Amira A A Othman; Amal A Z Dwedar; Hany M ElSadek; Hesham R AbdElAziz; Abeer A F Abdelrahman

doi:10.1016/j.amsu.2021.103168

Bile reflux gastropathy: Prevalence and risk factors after therapeutic biliary interventions: A retrospective cohort study

Ann Med Surg (Lond). 2021 Dec 6:72:103168. doi: 10.1016/j.amsu.2021.103168. eCollection 2021 Dec.

Authors

Amira A A Othman¹, Amal A Z Dwedar², Hany M ElSadek², Hesham R AbdElAziz³, Abeer A F Abdelrahman⁴

Affiliations

¹ Department of Internal Medicine, Faculty of Medicine, Suez University, Suez, Egypt.
² Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
³ Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
⁴ Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Abstract

Background: Bile reflux gastropathy is caused by the backward flow of duodenal fluid into the stomach. A retrospective cohort study was performed to declare if the therapeutic biliary interventions cause bile reflux gastropathy, and to estimate its prevalence and risk factors, and to evaluate the gastric mucosa endoscopic and histopathologic changes.

Methods: 62 patients, with epigastric pain and/or dyspeptic symptoms, were grouped into, Group 1 : (34) patients that had undergone cholecystectomy and Group 2 : (28) patients who had undergone at least one of the following procedures for the treatment of benign pathology: endoscopic sphincterotomy and endoscopic stenting. Their ages ranged from 27 to 59 years. All participants had undergone gastroscopy for gastric aspirate analysis as well as gastric mucosa biopsy for histopathological examination.

Results: the prevalence of bile reflux gastropathy was (21.34%) after therapeutic biliary interventions with a P-value of 0.000. In both groups, diabetes, obesity, increased gastric bilirubin, and increased gastric pH were risk factors for bile reflux gastropathy (r = 0.27, 0.31, 0.68, 0.59 respectively), while age, sex, epigastric pain, heartburn, vomiting were mot.

Conclusion: bile reflux gastropathy is common after therapeutic biliary interventions being more among obese and diabetic patients.

Keywords: Bile reflux; Bilirubin; Cholecystectomy; ERCP.