Background: Since the introduction of Laparoscopic Roux-en Y Gastric bypass (LRYGB) in 1994, surgical technique has been refined. Initially, a retrocolic retrogastric approach was favored, as this resembled the familiar open gastric bypass method. However, the antecolic antegastric approach has recently gained popularity due to ease of performance. Neither approach has conclusively demonstrated superior outcomes. We therefore compared the occurrence of dehydration in the postoperative period obtained using each of the techniques.
Methods: We reviewed the experience of a single surgeon who performed 474 consecutive LRYGB procedures. Seventy-one were performed from July 2003 to January 2004 using the retrocolic retrogastric approach, and 403 from January 2004 to June 2006 using the antecolic antegastric approach. Baseline characteristics including age, gender, comorbidities, social status and body mass index were similar in the two groups. The outcome was the rate of readmission for dehydration within a 30 day postoperative period.
Results: Of the 71 patients who underwent retrocolic retrogastric LRYGB, five (7%) were readmitted for dehydration within 30 days. Of the 403 patients who underwent antecolic antegastric LRYGB, eight (2%) were readmitted. Using a chi square analysis, the antecolic antegastric method was associated with fewer 30 day readmissions for dehydration. (p<0.025).
Conclusions: The antecolic antegastric approach to LRYGB may be associated with a reduced incidence of readmission for dehydration.