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Three-Year Results of Roux-en-Y Gastric Bypass-on-Vertical Banded Gastroplasty: an Effective and Safe Procedure which Enables Endoscopy and X-Ray Study of the Stomach and Biliary Tract

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Background

Cancer, perforation and bleeding in the bypassed stomach after RYGBP are rare but serious complications that require early diagnosis. Our goal was to perform a Roux-en-Y gastric bypass (RYGBP) whereby the traditional endoscopic and x-ray study of the bypassed stomach was possible, and at the same time obtain a good weight loss, similar to the standard RYGBP. We developed the RYGBP-on-Vertical banded gastroplasty (RYGBP on VBG), where a GoretexTM band surrounds the gastro-gastric outlet.

Methods

From June 2002 to September 2005, 128 patients, 94 female and 34 male, with age 50.5 ±14.8 SD years, BMI 51.6 ±7.2 SD kg/m2, and %EW 117.9 ±33.5 SD underwent RYGBP on VBG via an open approach. Radiological and, if necessary, endoscopic study has been carried out at 6 months, 1 year and then annually postoperatively.

Results

Two cases of anastomotic ulcer were detected, but no case of infection of the prosthetic material was found. Preoperative BMI fell from 51.6 ±7.2 to 38.1 ±6.6 after 6 months, to 35.0 ±7.1 after 1 year, to 34.4 ±6.1 after 2 years, and to 33.2 ±5.5 after 3 years.

Conclusion

RYGBP on VBG was effective; the weight loss curve, compared to standard RYGBP, is similar, while allowing the traditional x-ray and endoscopy of the bypassed stomach and thus the biliary tract.

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References

  1. Macgregor AM, Pikens NE, Thoburn EK. Perforated peptic ulcer following gastric bypass for obesity. Am Surg 1999; 65: 222–5.

    CAS  PubMed  Google Scholar 

  2. Papasavas PK, Yeaney WW, Caushaj PF et al. Perforation in the bypassed stomach following laparoscopic Roux-en-Y gastric bypass. Obes Surg 2003; 13: 797–99.

    Article  PubMed  Google Scholar 

  3. Mehran A, Szomstein S, Zundel N et al. Management of acute bleeding after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2003; 13: 842–7.

    Article  PubMed  Google Scholar 

  4. Nguyen NT, Rivers R, Wolfe BM. Early gastrointestinal hemorrahage after laparoscopic gastric bypass. Obes Surg 2003; 13: 62–5.

    Article  PubMed  Google Scholar 

  5. Spires WV, Morris DM. Bleeding duodenal ulcer after gastric bypass procedure for obesity. South Med J 1987; 80: 1325–6.

    Article  CAS  PubMed  Google Scholar 

  6. Printen Kj, LeFavre J, Alden J. Bleeding from the bypassed stomach following gastric bypass. Surg Gynecol Obstet 1983; 156: 65–6.

    CAS  PubMed  Google Scholar 

  7. Braley SC, Nguyen NT, Wolfe BM. Late gastrointestinal hemorrage after gastric bypass. Obes Surg 2002; 12: 404–7.

    Article  PubMed  Google Scholar 

  8. Lord RV, Edwards PD, Coleman MJ. Gastric cancer in the bypassed segment after operation for morbid obesity. Aust NZ J Surg 1997; 67: 580–2.

    Article  CAS  Google Scholar 

  9. Khitin L, Roses RE, Birkett DH. Cancer in the gastric remnant after gastric bypass: a case report. Curr Surg 2003; 60: 521–3.

    Article  PubMed  Google Scholar 

  10. Raijman I, Strother SV, Donegan WL. Gastric cancer after gastric bypass for obesity: case report. J Clin Gastroenterol 1991; 13: 191–4.

    Article  CAS  PubMed  Google Scholar 

  11. Corsini DA, Simoneti CA, Moreira G et al. Cancer in the excluded stomach 4 years after Gastric Bypass. Obes Surg 2006; 16: 932–4.

    Article  PubMed  Google Scholar 

  12. DeRoover A, Detry O, De Leval L et al. Report of two cases of gastric cancer after bariatric surgery: lymphoma of the bypassed stomach after Roux-en-Y gastric bypass and gastrointestinal stromal tumor (GIST) after vertical banded gastroplasty. Obes Surg 2006; 16: 928–31.

    Article  Google Scholar 

  13. Escalona A, Guzman S, Ibanez L et al. Gastric cancer after Roux-en-Y gastric bypass. Obes Surg 2005; 15: 423–7.

    Article  PubMed  Google Scholar 

  14. Fobi M, Chicola K, Lee H. Access to the bypassed stomach after gastric bypass. Obes Surg 1998; 8: 289–95.

    Article  CAS  PubMed  Google Scholar 

  15. Cariani S, Vittimberga G, Grani S et al. Prospective study on functional Roux-en-Y gastric bypass to avoid gastric exlusion. Obes Surg 2002; 12: 469.

    Google Scholar 

  16. Cariani S, Vittimberga G, Grani S et al. A functional Roux-en-Y gastric bypass to avoid gastric exclusion: 1-year results. Obes Surg 2003; 13: 788–91.

    Article  PubMed  Google Scholar 

  17. Cariani S, Lucchi A, Guerra M et al. Evolution of functional Roux-en-Y gastric bypass: from adjustable band to Gore-texTM band. Obes Surg 2004; 14: 471.

    Google Scholar 

  18. Cariani S, Lucchi A, Guerra M et al. Two-year results of Roux-en-Y gastric bypass on vertical banded gastroplasty: an effective and safe bariatric operation. Obes Surg 2005; 15: 974.

    Google Scholar 

  19. Cariani S, Palandri P, Faccani E et al. Roux-en-Y gastric bypass on vertical banded gastroplasty as a secondary operation: two Italian Hospitals’ surgical approach to restrictive procedure failures. Obes Surg 2005; 15: 974–5.

    Google Scholar 

  20. Hunter R, Watts JM, Dunstan R. Revisional surgery for failed gastric restrictive procedures in morbid obestity. Obes Surg 1992; 2: 245–52.

    Article  PubMed  Google Scholar 

  21. Sapala JA, Bolar RJ, Bell J et al. Technical strategies for converting the failed vertical banded gastroplasty to the Roux-en-Y gastric bypass. Obes Surg 1993; 3: 400–9.

    Article  PubMed  Google Scholar 

  22. Salmon PA. Gastroplasty/distal gastric bypass: an operation producing excellent and prolonged weight loss in the super-obese. Obes Surg 1993; 3: 391–6.

    Article  PubMed  Google Scholar 

  23. Himpens MJ, Rogge F, Leman G et al. Laparoscopic inflatable band with Roux-en-Y gastric bypass. Obes Surg 2001; 11: 528–31.

    Article  CAS  PubMed  Google Scholar 

  24. Gustavsson S, Sundbom M. Excellent weight result after Roux-en-Y gastric bypass in spite of gastro-gastric fistula. Obes Surg 2003; 13: 457–9.

    Article  PubMed  Google Scholar 

  25. Stanczyk M, Deveney C, Traxler SA et al. Gastro-gastric fistula in the era of divided Roux-en-Y gastric bypass: strategies for prevention, diagnosis, and management. Obes Surg 2006; 16: 359–64.

    Article  PubMed  Google Scholar 

  26. D’Hondt M, Vansteenkiste F, Van Rooy F et al. Gastrogastric fistula after gastric bypass — Is surgery always needed? Obes Surg 2006; 16: 1548–51.

    Article  PubMed  Google Scholar 

  27. Capella RF, Capella JF. Reducing early technical complications in gastric bypass surgery. Obes Surg 1997; 7:149–57.

    Article  CAS  PubMed  Google Scholar 

  28. Fobi MAL, Lee H, Igwe D Jr et al. Prospective comparative evaluation of stapled versus transected silastic ring gastric bypass: 6-year follow up. Obes Surg 2001; 11:18–24.

    Article  CAS  PubMed  Google Scholar 

  29. Cummings DE, Weigle DS, Scott Frayo R et al. Plasma ghrelin levels after diet induced weight loss or gastric bypass surgery. N Engl J Med 2002; 346: 1623–30.

    Article  PubMed  Google Scholar 

  30. De Roover A, Detry O, Desaive C et al. Risk of upper gastrointestinal cancer after bariatric operations. Obes Surg 2006; 16: 1656–61

    Article  PubMed  Google Scholar 

  31. Ross AS, Semrad C, Alverdy J et al. Use of doubleballoon enteroscopy to perform PEG in the excluded stomach after Roux-en-Y gastric bypass. Gastrointest Endosc 2006; 64: 797–800.

    Article  PubMed  Google Scholar 

  32. May A, Nachbar L, Ell C. Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease. Gastrointest Endosc 2005; 62: 62–70.

    Article  PubMed  Google Scholar 

  33. Wright BE, Cass OW, Freeman ML. ERCP in patients with long-limb Roux-en-Y gastrojejunostomy and intact papilla. Gastrointest Endosc 2002; 56: 225–32.

    Article  PubMed  Google Scholar 

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Correspondence to Stefano Cariani MD.

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Cariani, S., Amenta, E. Three-Year Results of Roux-en-Y Gastric Bypass-on-Vertical Banded Gastroplasty: an Effective and Safe Procedure which Enables Endoscopy and X-Ray Study of the Stomach and Biliary Tract. OBES SURG 17, 1312–1318 (2007). https://doi.org/10.1007/s11695-007-9234-8

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  • DOI: https://doi.org/10.1007/s11695-007-9234-8

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