Members Members Residents Job Board
Join Today Renew Your Membership Make A Donation
1998 Abstract: ROUX-EN-Y GASTRIC BY-PASS (RGBP) AFTER PREVIOUS UNSUCCESSFUL GASTRIC BARIATRIC SURGERY: EARLY RESULTS. A. Westling, M. Ljungdahl, S. Gustavsson. Dept of Surgery, University Hospital, Uppsala, Sweden. 69

Abstracts
1998 Digestive Disease Week

#973

ROUX-EN-Y GASTRIC BY-PASS (RGBP) AFTER PREVIOUS UNSUCCESSFUL GASTRIC BARIATRIC SURGERY: EARLY RESULTS. A. Westling, M. Ljungdahl, S. Gustavsson. Dept of Surgery, University Hospital, Uppsala, Sweden.

Gastric restrictive procedures like Vertical Banded Gastroplasty (VBG), Gastric Banding (GB) and Silicone-Adjustable Gastric Banding (SAGB) often fail to control weight in the long run or lead to intolerable side-effects. Here we review our experience with RGBP as a secondary bariatric operation. Methods. In the recent two-year period we performed RGBP in a total of 44 patients (41 females; median (range) age 42 (24 - 60) years), who previously had undergone VBG (n=15), GB (n=4) and SAGB (n=25). Five patients had had more than one previous bariatric procedure. After VBG the majority (n=11) of re-operations was done due to staple line disruption with resulting insufficient weight control (median BMI = 41 kg/m2). Band erosion (n= 11) and erosive esophagitis (n=10) were the most common reasons for re-operation after GB and SAGB (BMI = 31 kg/m2). Technically, the stomach was always divided with staplers and the vertical proximal pouch (4 × 3 cm) was made along the lesser curvature. The Roux limb was made > 50 cm long and was brought to the gastric pouch behind the colon and stomach. Results. The duration of surgery was 155 (85 - 240) min. 14 patients needed blood transfusion of a median of 3 (1 - 8) units. There was no mortality. The number of hospital days after operation was 6 (4 - 9). There were no obvious anastomotic leaks but two patients were re-laparotomised due to intraabdominal abscess and infected hematoma, respectively. Two patients developed stricture in the gastro-enteroanastomosis that had to be re-operated. Two patients were operated on due to mechanical ileus. Two patients were treated with anticoagulants due to deep venous thrombosis. Three patients developed stomal ulcers. At 6 and 12 months postop, median BMI was 29 and 28, respectively. Esophagitis symptoms resolved promptly. In global assessment 70 % of the patients were "very satisfied" and 30 % "satisfied" at follow up. Discussion. Even if postop morbidity was substantial we propose RGBP to be the method of choice when less complex gastric restrictive procedures fail to control weight or give intolerable side-effects and complications.

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.



Society for Surgery of the Alimentary Tract

Facebook Twitter YouTube

Email SSAT Email SSAT
500 Cummings Center, Suite 4400, Beverly, MA 01915 500 Cummings Center
Suite 4400
Beverly, MA 01915
+1 978-927-8330 +1 978-927-8330
+1 978-524-0498 +1 978-524-0498
Links
About
Membership
Publications
Newsletters
Annual Meeting
Join SSAT
Job Board
Make a Pledge
Event Calendar
Awards