One Thousand Consecutive Mini-Gastric Bypass: Short- and Long-term Outcome Authors
First Online: 13 March 2012 DOI:
Cite this article as: Noun, R., Skaff, J., Riachi, E. et al. OBES SURG (2012) 22: 697. doi:10.1007/s11695-012-0618-z
There is growing evidence that mini-gastric bypass (MGB) is a safe and effective procedure. Operative outcome and long-term follow-up of a consecutive cohort of patients who underwent MGB are reported. The data on 1,000 patients who underwent MGB from November 2005 to January 2011 at an academic institution were reviewed. Mean age was 33.15 ± 10.17 years (range, 14–72), preoperative BMI was 42.5 ± 6.3 kg/m
2 (range, 26–75), mean preoperative weight was 121.6 ± 23.8 kg (range, 71–240), and 663 were women. Operative time and length of stay for primary vs. revisional MGB were 89 ± 12.8 min vs. 144 ± 15 min ( p < 0.01) and l.85 ± 0.8 day vs. 2.35 ± 1.89 day ( p < 0.01). No deaths occurred within 30 days of surgery. Short-term complications occurred in 2.7% for primary vs. 11.6% for revisionnal MGB ( p < 0.01). Five (0.5%) patients presented with leakage from the gastic tube but none had anastomotic leakage. Four (0.4%) patients, all with revisionnal MGB, presented with severe bile reflux and were cured by stapling the afferent loop and by a latero-lateral jejunojejunostomy. Excessive weight loss occurred in four patients; two were reversed and two were converted to sleeve gastrectomy. Maximal percent excess weight loss (EWL) of 72.5% occurred at 18 months. Weight regain subsequently occurred with a mean variation of −3.9% EWL at 60 months. The 50% EWL was achieved for 95% of patients at 18 months and for 89.8% at 60 months. MGB is an effective, relatively low-risk, and low-failure bariatric procedure. In addition, it can be easily revised, converted, or reversed.
Omega loop gastric bypass
Rutledge R. The mini-gastric bypass: experience with the 1.274 cases. Obes Surg. 2001;11:276–80.
Wang HH, Wei PL, Lee YC, et al. Short-term results of laparoscopic mini-gastric bypass. Obes Surg. 2005;15:648–54.
Noun R, Zeidan S. Laparoscopic mini-gastric bypass: an effective option for the treatment of morbid obesity. J Chir (Paris). 2007;144:301–4.
Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.
Lee WJ, Chen JC, Ser KH. Laparoscopic mini-gastric bypass versus Roux-en-Y gastric bypass: 5-year results and final report of a randomized trial. 14th World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders. Paris, August 2009.
Gastrointestinal surgery for severe obesity. National Institutes of Health Consensus Development Conference Draft Statement. Obes Surg. 1991;1:257–66.
Deitel M, Shabi B. Morbid obesity: selection of patients for surgery. J Am Coll Nutr. 1992;11:457–62.
Noun R, Riachi E, Zeidan S, et al. Mini-gastric bypass by Mini-laparotomy: a cost-effective alternative in the laparoscopic era. Obes Surg 2007; 1482-86.
DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–7.
Flum DR, Salem L, Elrod JAB, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294:1903–8.
Sanchez-Santos R, Estevez S, Tome C et al. Training program influence in the learning curve of laparoscopic gastric bypass for morbid obesity. Obes Surg 2011, 1. DOI: 10.1007/s11695-011-0398-x
Chakhtoura G, Zinzindohoue F, Ghanem Y, et al. Primary results of laparoscopic mini-gastric bypass in a french obesity-surgery specialized university hospital. Obes Surg. 2008;18:1130–3.
Marshall JS, Srivastava A, Gupta SK, et al. Roux-en-Y leak complications. Arch Surg. 2003;138:523–4.
Carucci LR, Turner MA, Conklin RC, et al. Roux-enY gastric bypass surgery for morbid obesity: evaluation of postoperative extraluminal leaks with upper gastrointestinal series. Radiology. 2006;238:119–27.
Zingg U, McQuinn A, DiValentino D, et al. Revisionnal vs primary Roux-en-Y gastric bypass a case-matched analysis. Obes Surg. 2010;20:1627–32.
Christou N, Efthimiou E. Five-year outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in a comprehensive bariatric surgery program in Canada. Can J Surg. 2009;52:249–58.
Helling T, Balliro J. The lethality of obstructing hematoma at the jejunojejunostomy following Roux-enY gastric bypass (correspondance). Obes Surg. 2005;15:290–3.
Eckhauser A, Torquati A, Youssef Y, et al. Internal hernia: postoperative complication of Roux-en-Y gastric bypass surgery. Obes Surg. 2006;7:581–5.
Naef M, Mouton W, Wagner H. Small bowel volvulus in late pregnancy due to internal hernia after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2010;20:1737–9.
Paroz A, Calmes JM, Giusti V, et al. Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity: a continuous challenge in bariatric surgery. Obes Surg. 2006;16:1482–7.
Gazzalle A, Braun D, Cavazolla LT, et al. Late intestinal obstruction due to an intestinal volvulus in a pregnant patient with a previous Roux-en-Y gastric bypass. Obes Surg. 2010;20:1740–2.
Noun R, Zeidan S, Safa N. Laparoscopic latero-lateral jejuno-jejunostomy as a rescue procedure after complicated mini-gastric bypass. Obes Surg. 2006;16:1539–41.
Jones KB. Biliopancreatic limb obstruction in gastric bypass at or proximal to the jejunojejunostomy: a potentially deadly catastrophic event. Obes Surg. 1996;6:485–93.
Iannelli A, Amato D, Addeo P, et al. Laparoscopic conversion of vertical gastroplasty into Roux-en-Y gastric Bypass. Obes Surg. 2008;1:43–6.
Gumbs A, Pomp A, Gagner M. Revisionnal bariatric surgery for inadequate weight loss. Obes Surg. 2007;17:1137–45.
Ballesta C, Berindoague R, Cabrera M, et al. Management of anastomotic leaks after laparoscopic roux-en-Y gastric bypass. Obes Surg. 2008;18:623–30.
Wang W, Huang MT, Wei PL, et al. Laparoscopic mini-gastric bypass for failed vertical banded gastroplasty. Obes Surg. 2004;14:777–82.
Schouten R, Van Dielen FM, Van Gemert WG, et al. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17:622–30.
Noun R, Zeidan S, Riachi E, et al. Mini-gastric bypass for revision of failed primary restrictive procedures: a valuable option. Obes Surg. 2007;17:684–8.
Brolin R, Cody R. Impact of technological advances on complications of revisional bariatric operations. J Am Coll Surg. 2008;206:1137–44.
Rutledge R, Walsh T. Continued excellent results with the mini-gastric bypass: six-year study in 2410 patients. Obes Surg. 2005;15:1304–8.
Lee WJ, Wang W, Lee YC, et al. Laparoccopic mini-gastric ypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18:294–9.
Padwal R, Klarenbach S, Wiebe N, et al. Bariatric surgery: a systematic review and network meta-analysis of randomized trials. Obes Rev. 2011;28:1467–789.
Sanchez-Pernaute A, Rubio-herera MA, Perez-Aguirre ME, et al. Single anatomosis duodeno-ileal bypass with sleeve gastectomy. One to three-year follow-up. Obes Surg. 2010;20:1720–6.
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