Gastric pouch resizing for Roux-en-Y gastric bypass failure in patients with a dilated pouch.

Abstract

BACKGROUND:

Insufficient weight loss or weight regain a few years after laparoscopic Roux-en-Y gastric bypass is becoming a serious problem given the large diffusion of this procedure. In the present study, we analyzed the feasibility and safety of pouch resizing for Roux-en-Y gastric bypass failure in a consecutive series of 20 patients at a university hospital.

METHODS:

A prospectively maintained database was queried regarding patient demographics, the indication for revision morbidity, the percentage of excess weight loss, and the evolution of co-morbidities.

RESULTS:

A total of 20 patients, 18 women and 2 men, with a mean age of 44 years and mean body mass index of 45.8 kg/m(2), underwent pouch resizing. No patients died; 6 patients (30%) developed complications, including acute abdomen due to volvulus of the small bowel in 1, intra-abdominal abscess in 3, and pulmonary embolus in 2. At a mean follow-up of 20 months, the percentage of excess weight loss was an average of 69.1% and persistent co-morbidities had improved or resolved.

CONCLUSION:

Pouch resizing has been shown to be a valuable option in the short term for weight loss failure or regain in patients who have undergone laparoscopic Roux-en-Y gastric bypass and have a dilated gastric pouch. However, the long-term efficacy of this procedure needs to be determined.

• Authors: Antonio Iannelli, Anne-Sophie Schneck, Xavier Hébuterne, Jean Gugenheim
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2013 Mar-Apr Vol. 9 Issue 2 Pg. 260-7 ISSN: 1878-7533 [Electronic] United States
• PMID: 22695174 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Dilatation, Pathologic (etiology, surgery)
• Feasibility Studies
• Female
• Gastric Bypass (methods)
• Humans
• Laparoscopy (methods)
• Male
• Obesity, Morbid (pathology, surgery)
• Postoperative Complications (etiology)
• Prospective Studies
• Reoperation
• Stomach (pathology, surgery)
• Treatment Failure
• Weight Loss (physiology)