Volume 24, Issue 106, November - December, 2020

Roux en Y gastric bypass after failed primary restrictive procedures in morbidly obese patients

Amr Elgazar^♦, Medhat Khalil, Haitham Elmaleh, Alaa Abbass Mustafa

General surgery department, Faculty of Medicine, Ain shams University, Cairo, Egypt

^♦Corresponding author
General surgery department, Faculty of Medicine, Ain shams University, Cairo, Egypt; Email: amremamameen1989@gmail.com

ABSTRACT

Background: Worldwide prevalent over the past several decades, Obesity morbidities and health related adverse effects has been an increasing concern that lead to revolutionary advancements in the field of bariatric surgery. The long-term outcomes of the different techniques in have gained popularity in the last years. Although sleeve gastrectomy is being performed with increasing frequency as well as other restrictive procedures. Failure or inadequate satisfactory outcome of these procedures became interestingly evident and thoroughly studied ranging from regaining of the preliminary lost weight, insufficient weight loss, GERD, and various other complications all of which determine a failure of the primary procedure. Methods: This prospective study included 40 patients who underwent a revisional surgery in the form of Roux en y gastric bypass after they failed to achieve significant weight loss from their primary bariatric operations. Roux en y gastric bypass procedures were done from the period of January 2018 till January 2019 and the patient were followed after for one year. Results: Each patient had different indication for the revisional Roux en y gastric bypass conversion: 18 patients (45%) due to weight regain after 1yr weight loss, 14 patients (35%) due to insufficient weight loss, and 8 patients (20%) due to GERD. Roux en y gastric bypass was performed with significant reduction of both mean weight of the patients from 113.50±9.92 kg to 98.65±9.93 and 89.18±9.84 after 6, and 12 months respectively and mean BMI from 39.06±4.91 before the conversion to 33.93±4.44 and 30.65±4.11 at 6 and 12 months respectively. Moreover, co-morbidities such as Diabetes and Hypertension were markedly improved in addition to the lipid profile of most of the patients. Conclusion: Roux en y gastric bypass is a safe procedure that can be recommended as a first line revisional surgery after failed primary restrictive bariatric procedures to achieve significant weight reduction and to improve any of the obesity related comorbidities.

Keywords: Laparoscopic sleeve gastrectomy, Roux-en-Y gastric bypass, Restrictive procedures, VBG, Revisional surgery

Medical Science, 2020, 24(106), 4166-4177

PDF