Adelaide Medical School
Faculty of Health and Medical Sciences
Dr Tom Eldredge is a General Surgery trainee with the Royal Australasian College of Surgeons. After completing his medical degree in 2014 at the University of Adelaide, he undertook his internship at the Royal Adelaide Hospital, taking a keen interest in teaching and subsequently being appointed as a Clinical Associate Lecturer of the University of Adelaide. Currently undertaking a PhD, Tom is researching bile reflux in the setting of bariatric surgery and the effect this has on oesophageal function and development of cancer.
My research investigates the incidence, pathophysiology and sequelae of bile reflux in the context of bariatric surgery.
Nearly two-thirds of Australian adults are overweight or obese – more than two-thirds (70.8%) of adult males, and over half (56.3%) of adult females. Medical treatment of obesity continues to yield disappointing results. Obesity surgery consistently results in effective and sustained weight loss with improved quality of life, and remission of obesity-related diseases. As such, many Australians are turning to surgery to lose weight.
Obesity is an independent risk factor for development of reflux and weight-loss can significantly improve symptoms. Some weight-loss operations, however, can promote bile reflux due to the anatomical alterations, and symptomatic reflux can persist despite weight loss. Bile acids, in conjunction with gastric acid, can cause reflux-type symptoms, and also the development of Barrett’s oesophagus which is a pre-cursor for oesophageal cancer.
Recent advances in obesity surgery include the introduction of new surgical techniques. Currently, the laparoscopic Roux-en-Y gastric bypass (LRYGP) and laparoscopic sleeve gastrectomy (LSG) are the most commonly performed surgical procedures for weight loss worldwide. A newer alternative operative technique is the laparoscopic single anastomosis gastric bypass (LSAGB). This technique is growing in popularity and as described by proponents of the technique, there are many advantages: it is quicker to learn; has a shorter operative time (and thus shorter anaesthetic); reduces risk of complications (one anastomosis rather than two) and weight loss as well as glucose tolerance outcomes are comparable to the other techniques. Despite these results, LSAGB is not being as rapidly adopted by bariatric surgeons as might be expected. The low uptake relates to controversy concerning the theoretical long-term harm and potentially carcinogenic effects of bile reflux into the gastric remnant and the oesophagus after LSAGB.
My clinical trial is the first objective study looking at the incidence of bile reflux in these operative techniques.With current data showing favourable results, including improved efficacy and decreased risk of complications, increased utilisation of the technique will result in improved short-term and long-term patient outcomes. Awareness of the incidence of bile reflux post-operatively will allow clinicians to treat any reflux early, preventing or at least delaying potentially detrimental health outcomes. These interventions will translate into decreased health expenditure, providing net health and economic benefit.
Date Position Institution name 2015 - ongoing Clinical Lecturer University of Adelaide
Awards and Achievements
Date Type Title Institution Name Country Amount 2021 Research Award Early Career Researcher Award Australian & New Zealand Metabolic and Obesity Surgery Society Australia 2019 Award Best Poster and Mini-Oral Presentation (Clinical Projects) 2019 TQEH Research Expo Australia 500 2019 Scholarship RP Jepson Research Scholarship Royal Australasian College of Surgeons Australia $66,000
Date Institution name Country Title 2016 University of Adelaide Australia Doctor of Philosophy (PhD) 2009 - 2014 University of Adelaide Australia Bachelor of Medicine / Bachelor of Surgery (MBBS)
Date Title Institution Country 2019 General Surgery Training Royal Australasian College of Surgeons Australia 2018 - 2019 Surgical Registrar Royal Adelaide Hospital Australia 2016 - 2018 Surgical Residency Central Adelaide Local Health Network Australia 2015 - 2016 Internship Royal Adelaide Hospital Australia
Year Citation 2022 Eldredge, T. A., Bills, M., Ting, Y. Y., Dimitri, M., Watson, M. M., Harris, M. C., . . . Shenfine, J. (2022). Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery. Obesity Surgery, 32(5), 1428-1438.
2022 Gricks, B., Eldredge, T., Bessell, J., & Shenfine, J. (2022). Outcomes of 325 one anastomosis gastric bypass operations: an Australian case series.. ANZ journal of surgery.
2021 Han, J., Eldredge, T., McQuillan, P., & Prasad, S. (2021). Rare complication of diaphragmatic hernia in a live donor nephrectomy patient. ANZ Journal of Surgery, 91(4), E235-E237.
2021 Barbaro, A., Eldredge, T. A., & Shenfine, J. (2021). Diagnosing anastomotic leak post-esophagectomy: a systematic review. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 34(2), 15 pages.
DOI Scopus2 WoS2 Europe PMC1
2020 Eldredge, T. A., Bills, M., Myers, J. C., Bartholomeusz, D., Kiroff, G. K., & Shenfine, J. (2020). HIDA and Seek: Challenges of Scintigraphy to Diagnose Bile Reflux Post-Bariatric Surgery. Obesity Surgery, 30(5), 2038-2045.
DOI Scopus2 WoS1 Europe PMC1
2018 Eldredge, T., Myers, J., Kiroff, G., & Shenfine, J. (2018). Detecting Bile Reflux—the Enigma of Bariatric Surgery. Obesity Surgery, 28(2), 559-566.
DOI Scopus11 WoS8 Europe PMC6
2018 Eldredge, T., Myers, J., Kiroff, G., & Shenfine, J. (2018). Response to a letter to the editor Re: Detecting bile reflux—the enigma of bariatric surgery. Obesity Surgery, 28(7), 2052.
2018 Eldredge, T. A., Harley, S. J. D., Warren, L. R., & Shenfine, J. (2018). Doctor–doctor: the impact of early career higher degrees in surgical research. ANZ Journal of Surgery, 88(9), 820-822.
2016 Rajak, S. N., Eldredge, T. A., Rashid, F., & Brittain, G. P. (2016). IgG4-related orbital disease mass lesion. Canadian Journal of Ophthalmology, 51(2), e70-e72.
DOI Scopus2 WoS1 Europe PMC1
2016 Eldredge, T., Rajak, S., Taranath, A., & Selva, D. (2016). Proptosis secondarytoorbital bone remodeling from intracranial hypertension. JAMA Ophthalmology, 134(6), 714-716.
|2018||1||Royal Australasian College of Surgeons||$66,000|
Tom has been appointed as a Clinical Associate Lecturer within the University of Adelaide and is involved with clinical teaching. He is an oral assessor for entry into the medical program and an examiner for medical student clinical examinations.
|2019 - current||Instructor - Early Management of Severe Trauma (EMST)||Royal Australasian College of Surgeons||-|
|2016 - 2017||Anatomy Demonstrator||University of Adelaide||Discipline of Anatomy and Pathology|
|2015 - 2018||Clinical Bedside Tutorials||University of Adelaide||Clinical Education|
|2012||Anatomy Tutor||St Marks College Adelaide||-|
Date Role Committee Institution Country 2015 - ongoing Member Trainee Medical Officers Systems Improvement Group Royal Adelaide Hospital Australia 2015 - 2016 Member Resident Medical Officers' Society Royal Adelaide Hospital Australia
Date Role Membership Country 2019 - ongoing Member General Surgeons Australia Australia 2019 - ongoing Member Royal Australasian College of Surgeons Australia
Date Topic Presented at Institution Country 2021 - 2021 Biliary Scintigraphy provides accurate data on the incidence and extent of bile reflux post-bariatric surgery Annual Scientific Meeting 2021 Australia and New Zealand Society of Nuclear Medicine 2019 - 2019 Challenges for Medical Imaging of Bile Reflux after Obesity Surgery TQEH 2019 Research Expo Basil Hetzel Institute Australia 2018 - 2018 Investigation of Problematic Reflux Symptoms Post-Bariatric Surgery 2018 Annual Conference Australia and New Zealand Metabolic and Obesity Surgery Society 2018 - 2018 Detecting Bile Reflux - The Enigma of Bariatric Surgery SA Training Committee Registrar’s Paper Day General Surgeons Australia 2017 - 2017 Surgical Research Quality and Output Amongst Junior Doctors in South Australia: A Cross-Sectional Study Annual Scientific Congress Royal Australasian College of Surgeons
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