{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:22:41Z","timestamp":1772068961094,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,5,29]]},"abstract":"<jats:p>Bile reflux into the gastric stump and then into the oesophagus is a common event after distal gastrectomy and Billroth II reconstruction. In addition to typical symptoms of nausea, epigastric pain and bile vomiting, acid reflux can also occur in patients with concomitant hiatus hernia and lower oesophageal sphincter incompetency. Diverting the bile away from the oesophagus by conversion into a Roux-en-Y anastomosis or by completion gastrectomy and Roux-en-Y esophagojejunostomy have so far represented the mainstay of treatment. We report the first case of magnetic sphincter augmentation to relieve refractory reflux symptoms after Billroth II gastrectomy. The procedure was performed through a laparoscopic approach and proved very effective at 1-year follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2018-225364","type":"journal-article","created":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T03:45:20Z","timestamp":1528429520000},"page":"bcr-2018-225364","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Magnetic sphincter augmentation is an effective option for refractory duodeno-gastro-oesophageal reflux following Billroth II gastrectomy"],"prefix":"10.1136","volume":"2018","author":[{"given":"Matteo","family":"Melloni","sequence":"first","affiliation":[{"name":"Department of Surgery, Universita degli Studi di Milano, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Lazzari","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universita degli Studi di Milano, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Asti","sequence":"additional","affiliation":[{"name":"Department of Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Lombardia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4880-1670","authenticated-orcid":false,"given":"Luigi","family":"Bonavina","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universita degli Studi di Milano, Milano, Italy"},{"name":"IRCCS Policlinico San Danato, San Donato Milanese, Lombardia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,8]]},"reference":[{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1002\/bjs.1800700702","article-title":"Bile reflux and the Roux en Y anastomosis","volume":"70","author":"Earlam","year":"1983","journal-title":"Br J Surg"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/SLA.0b013e3181921aa1","article-title":"Latest results (12-21 years) of a prospective randomized study comparing Billroth II and Roux-en-Y anastomosis after a partial gastrectomy plus vagotomy in patients with duodenal ulcers","volume":"249","author":"Csendes","year":"2009","journal-title":"Ann Surg"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-008-0698-1"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2013.04.039"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.5","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00464-014-3772-7","article-title":"Magnetic sphincter augmentation and fundoplication for GERD in clinical practice: one-year results of a multicenter, prospective observational study","volume":"29","author":"Riegler","year":"2015","journal-title":"Surg Endosc"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.6","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.cgh.2015.05.028","article-title":"Long-term Outcomes of Patients Receiving a Magnetic Sphincter Augmentation Device for Gastroesophageal Reflux","volume":"14","author":"Ganz","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.7","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ijsu.2018.02.041","article-title":"Early results of magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: Systematic review and meta-analysis","volume":"52","author":"Aiolfi","year":"2018","journal-title":"Int J Surg"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.8","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1308\/rcsann.2017.0224","article-title":"Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux - results and challenges","volume":"100","author":"Prakash","year":"2018","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.9","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1097\/SLA.0000000000001785","article-title":"Removal of the Magnetic Sphincter Augmentation Device: Surgical Technique and Results of a Single-center Cohort Study","volume":"265","author":"Asti","year":"2017","journal-title":"Ann Surg"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.10","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1089\/lap.2017.0025","article-title":"Lower Esophageal Sphincter Augmentation for Gastroesophageal Reflux Disease: The Safety of a Modern Implant","volume":"27","author":"Smith","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.11","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1007\/s00464-017-5859-4","article-title":"Favorable results from a prospective evaluation of 200 patients with large hiatal hernias undergoing LINX magnetic sphincter augmentation","volume":"32","author":"Buckley","year":"2018","journal-title":"Surg Endosc"},{"key":"2025082700325650000_2018.jun06_2.bcr-2018-225364.12","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ijscr.2016.11.050","article-title":"Laparoscopic management of severe reflux after sleeve gastrectomy using the LINX\u00ae system: Technique and one year follow up case report","volume":"30","author":"Hawasli","year":"2017","journal-title":"Int J Surg Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:33:04Z","timestamp":1756279984000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,8]]},"references-count":12,"alternative-id":["10.1136\/bcr-2018-225364"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225364","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,8]]}}}