{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:47:06Z","timestamp":1782935226668,"version":"3.54.5"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002352","name":"Ain Shams University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>After Single Anastomosis Sleeve Jejunal (SASJ) bypass, biliary reflux is a challenging postoperative issue that may require revisional intervention. Conversion to Roux-en-Y gastric bypass (RYGB) and revision to sleeve gastrectomy are two frequently used techniques. Their clinical results are assessed and contrasted in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Forty patients were the subject of a prospective comparative analysis presenting with persistent biliary reflux after SASJ despite medical therapy. Patients were managed by either conversion to RYGB (Group A,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922) or revision to sleeve gastrectomy (Group B,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918). Reflux resolution, gastroesophageal reflux disease (GERD), perioperative outcomes, and weight changes were among the outcomes evaluated over a 12-month period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The two groups\u2019 baseline characteristics were comparable (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). The RYGB group had significantly longer operating times and longer hospital stays (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036). While 27.8% of patients in the sleeve group had persistent reflux, all patients undergoing RYGB showed complete resolution of biliary reflux (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). GERD outcomes improved in Group A but significantly worsened in Group B (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Weight evolution favored RYGB, demonstrating sustained BMI reduction, while sleeve revision was associated with progressive weight regain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RYGB conversion was associated with more reliable reflux resolution and better overall clinical outcomes compared with sleeve revision. To validate these results, more extensive research is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08772-5","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:19:57Z","timestamp":1781151597000},"page":"3441-3445","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revisional Surgical Options After Single Anastomosis Sleeve Jejunal Bypass for Refractory Biliary Reflux: A Prospective Comparative Study Between Roux-en-Y Gastric Bypass and Reversal to Sleeve Gastrectomy"],"prefix":"10.1007","volume":"36","author":[{"given":"Mohamed A.","family":"Elshimy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Farrag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamal M.","family":"Abdalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"issue":"9","key":"8772_CR1","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1038\/nrgastro.2017.80","volume":"14","author":"PC Lee","year":"2017","unstructured":"Lee PC, Dixon J. Medical devices for the treatment of obesity. Nat Rev Gastroenterol Hepatol. 2017;14(9):553\u201364.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"2","key":"8772_CR2","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1007\/s11695-020-04945-y","volume":"31","author":"M Khalaf","year":"2021","unstructured":"Khalaf M, Hamed HJOS. Single-Anastomosis Sleeve Ileal (SASI) Bypass: Hopes and Concerns after a Two-Year Follow-up. Obes Surg. 2021;31(2):667\u201374.","journal-title":"Obes Surg"},{"issue":"2","key":"8772_CR3","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/SLA.0000000000003275","volume":"271","author":"KTD Yeung","year":"2020","unstructured":"Yeung KTD, Penney N, Ashrafian L, et al. Does sleeve gastrectomy expose the distal esophagus to severe reflux? a systematic review and meta-analysis. Ann Surg. 2020;271(2):257\u201365.","journal-title":"Ann Surg"},{"key":"8772_CR4","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijsu.2016.08.018","volume":"34","author":"T Mahdy","year":"2016","unstructured":"Mahdy T, Schou CJIOS. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure\u2014retrospective cohort study. Int J Surg. 2016;34:28\u201334.","journal-title":"Int J Surg"},{"issue":"11","key":"8772_CR5","doi-asserted-by":"publisher","first-page":"3769","DOI":"10.1007\/s11695-019-04016-x","volume":"29","author":"A Pazouki","year":"2019","unstructured":"Pazouki A, Kermansaravi M. Single anastomosis sleeve-jejunal bypass: a new method of bariatric\/metabolic surgery. Obes Surg. 2019;29(11):3769\u201370.","journal-title":"Obes Surg"},{"key":"8772_CR6","doi-asserted-by":"publisher","first-page":"106662","DOI":"10.1016\/j.ijsu.2022.106662","volume":"102","author":"AM Sewefy","year":"2022","unstructured":"Sewefy AM, Atyia AM, Mohammed MM, et al. Single anastomosis sleeve jejunal (SAS-J) bypass as a treatment for morbid obesity: technique and review of 1986 cases and 6 years follow-up. Int J Surg. 2022;102:106662.","journal-title":"Int J Surg"},{"key":"8772_CR7","doi-asserted-by":"publisher","first-page":"111642","DOI":"10.1016\/j.ijscr.2025.111642","volume":"133","author":"A Fontaine-Nicola","year":"2025","unstructured":"Fontaine-Nicola A, Cambuli-Bianchi P, Sadiq KO, et al. Refractory bile reflux following one-anastomosis gastric bypass: A case report and literature review. Int J Surg Case Rep. 2025;133:111642.","journal-title":"Int J Surg Case Rep"},{"issue":"2","key":"8772_CR8","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.soard.2016.10.022","volume":"13","author":"A Nimeri","year":"2017","unstructured":"Nimeri A, Al Shaban T, Maasher A. Conversion of one-anastomosis gastric bypass to Roux-en-Y gastric bypass for bile reflux gastritis after failed Braun jejunojejunostomy. Surg Obes Relat Dis. 2017;13(2):361\u20133.","journal-title":"Surg Obes Relat Dis"},{"issue":"2","key":"8772_CR9","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s11695-017-2885-1","volume":"28","author":"MM Shenouda","year":"2018","unstructured":"Shenouda MM, Harb SE, Mikhail SA, et al. Bile gastritis following laparoscopic single anastomosis gastric bypass: significance of bilirubin in gastric aspirate. Obes Surg. 2018;28(2):389\u201395.","journal-title":"Obes Surg"},{"issue":"1","key":"8772_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.soard.2024.10.003","volume":"21","author":"RW Vosburg","year":"2025","unstructured":"Vosburg RW, Nimeri A, Azagury D, et al. ASMBS literature review on the treatment of marginal ulcers after metabolic and bariatric surgery. Surg Obes Relat Dis. 2025;21(1):1\u20138.","journal-title":"Surg Obes Relat Dis"},{"issue":"8","key":"8772_CR11","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1007\/s11695-017-2608-7","volume":"27","author":"T Saarinen","year":"2017","unstructured":"Saarinen T, R\u00e4s\u00e4nen J, Salo J, et al. Bile reflux scintigraphy after mini-gastric bypass. Obes Surg. 2017;27(8):2083\u20139.","journal-title":"Obes Surg"},{"key":"8772_CR12","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.soard.2021.10.019","volume":"18","author":"J Jedamzik","year":"2022","unstructured":"Jedamzik J, Bichler C, Felsenreich DM, et al. Conversion from one-anastomosis gastric bypass to Roux-en-Y gastric bypass: when and why? Surg Obes Relat Dis. 2022;18:225\u201332.","journal-title":"Surg Obes Relat Dis"},{"issue":"3","key":"8772_CR13","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1007\/s11695-023-07050-y","volume":"34","author":"N Sargsyan","year":"2024","unstructured":"Sargsyan N, Das B, Robb H. Outcomes of one-anastomosis gastric bypass conversion to Roux-en-Y gastric bypass for severe obesity: systematic review & meta-analysis. Obes Surg. 2024;34(3):976\u201384.","journal-title":"Obes Surg"},{"key":"8772_CR14","first-page":"1235","volume":"30","author":"SS Shah","year":"2020","unstructured":"Shah SS, Todkar JS. Roux-en-Y gastric bypass for intractable bile reflux after one-anastomosis gastric bypass: long-term outcomes. Obes Surg. 2020;30:1235\u201342.","journal-title":"Obes Surg"},{"key":"8772_CR15","doi-asserted-by":"publisher","first-page":"6220","DOI":"10.1007\/s00464-023-10112-y","volume":"37","author":"E Aghajani","year":"2023","unstructured":"Aghajani E, Schou C, Gislason H, Nergaard BJ. Midterm outcomes after single anastomosis sleeve ileal (SASI) bypass. Surg Endosc. 2023;37:6220\u20137.","journal-title":"Surg Endosc"},{"issue":"8","key":"8772_CR16","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1016\/j.soard.2019.05.026","volume":"15","author":"M Musella","year":"2019","unstructured":"Musella M, Milone M, Boschi S, et al. Rise of biliary reflux after one-anastomosis gastric bypass: pathophysiology & management. Surg Obes Relat Dis. 2019;15(8):1394\u2013400.","journal-title":"Surg Obes Relat Dis"},{"issue":"39","key":"8772_CR17","first-page":"14224","volume":"20","author":"F Rebecchi","year":"2014","unstructured":"Rebecchi F, Allaix ME, Patti MG, et al. GERD and laparoscopic sleeve gastrectomy: pathophysiology and prevention. World J Gastroenterol. 2014;20(39):14224\u201332.","journal-title":"World J Gastroenterol"},{"issue":"1","key":"8772_CR18","first-page":"40","volume":"17","author":"EE Frezza","year":"2007","unstructured":"Frezza EE. Long-term GERD control after Roux-en-Y gastric bypass. Obes Surg. 2007;17(1):40\u20135.","journal-title":"Obes Surg"},{"issue":"3","key":"8772_CR19","first-page":"312","volume":"146","author":"D Stefanidis","year":"2011","unstructured":"Stefanidis D, Kuwada TS, Gersin KS. The impact of RYGB on GERD: mechanisms and outcomes. Arch Surg. 2011;146(3):312\u20138.","journal-title":"Arch Surg"},{"issue":"1","key":"8772_CR20","first-page":"27","volume":"30","author":"B Qumseya","year":"2020","unstructured":"Qumseya B, Bitar A, Rachel A, et al. Systematic review and meta-analysis: LSG and GERD. Obes Surg. 2020;30(1):27\u201335.","journal-title":"Obes Surg"},{"issue":"3","key":"8772_CR21","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/SLA.0b013e31824856f5","volume":"255","author":"CW le Roux","year":"2012","unstructured":"le Roux CW, Welbourn R, Werling M, et al. Gut hormone changes after bariatric surgery favor GLP-1\u2013mediated metabolic improvement. Ann Surg. 2012;255(3):405\u201311.","journal-title":"Ann Surg"},{"key":"8772_CR22","doi-asserted-by":"publisher","first-page":"2002","DOI":"10.1056\/NEJMoa1401329","volume":"370","author":"PR Schauer","year":"2014","unstructured":"Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery vs medical therapy for diabetes: 3-year outcomes. N Engl J Med. 2014;370:2002\u201313.","journal-title":"N Engl J Med"},{"issue":"3","key":"8772_CR23","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1007\/s00464-015-4315-6","volume":"30","author":"RC Moon","year":"2016","unstructured":"Moon RC, Teixeira AF, Snyder B, et al. Revisional bariatric surgery outcomes: RYGB vs SG. Surg Endosc. 2016;30(3):1227\u201332.","journal-title":"Surg Endosc"},{"issue":"2","key":"8772_CR24","first-page":"273","volume":"269","author":"PE O\u2019Brien","year":"2019","unstructured":"O\u2019Brien PE, Dixon JB, Laurie C, et al. Ten-year outcomes after RYGB: durable weight-loss evidence. Ann Surg. 2019;269(2):273\u201381.","journal-title":"Ann Surg"},{"issue":"6","key":"8772_CR25","first-page":"1017","volume":"13","author":"M Bhandari","year":"2017","unstructured":"Bhandari M, Fobi MA, Buchwald JN. Reversal procedures after bariatric surgery and their outcomes. Surg Obes Relat Dis. 2017;13(6):1017\u201327.","journal-title":"Surg Obes Relat Dis"}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-026-08772-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-026-08772-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-026-08772-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:54:15Z","timestamp":1782928455000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11695-026-08772-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["8772"],"URL":"https:\/\/doi.org\/10.1007\/s11695-026-08772-5","relation":{},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"value":"0960-8923","type":"print"},{"value":"1708-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"24 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approved by the Ain Shams University Institutional Review Board. Every procedure adhered to ethical guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}