Background: Laparoscopic mini gastric bypass is widely performed for the treatment of morbid obesity due to its metabolic efficacy and technical simplicity. However, concerns remain regarding postoperative bile reflux associated with its loop configuration.

Objective: To evaluate the incidence and clinical significance of bile reflux following conventional laparoscopic mini gastric bypass in a single-center cohort.

Methods: A retrospective analysis was conducted on 68 consecutive patients who underwent con-ventional mini gastric bypass between 2021 and 2023. Patients were stratified according to pre-operative gastroesophageal reflux status. Early postoperative outcomes were assessed at 30 days, including endoscopic visualization of bile in the gastric pouch and reflux-related symptoms. Mid-term outcomes at 12 months included excess weight loss (%EWL), reflux dynamics, and quality-of-life evaluation.

Results: At 30 days, bile was visualized endoscopically in 90.6% of patients with preoperative re-flux and in 47.2% of those without prior reflux (p < 0.001). De novo reflux symptoms developed in 27.8% of previously asymptomatic patients. Most patients in both subgroups achieved ≥50% EWL at 12 months, with greater weight loss seen in those without preoperative reflux.  Complete resolution of reflux symptoms occurred in 18.8% of patients with baseline reflux, whereas persis-tent or partially regressed symptoms remained common. Quality-of-life improvement was observed overall but was lower in patients with ongoing reflux manifestations.

Conclusion: Conventional mini gastric bypass ensures effective weight loss but is associated with a high incidence of early bile reflux, particularly in patients with preoperative gastroesophageal re-flux disease, and not negligible even in initially asymptomatic individuals.

Mini gastric bypass, bile reflux, gastroesophageal reflux

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