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Indications and Operative Outcomes of Gastric Bypass Reversal

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Abstract

Background

Roux-en-Y gastric bypass (RYGB) is one of the best-known and most commonly performed bariatric procedures. However, this procedure carries infrequent but serious long-term complications, which may require revisional procedures. This study reports the indications and outcomes of gastric bypass reversal that have not been described well in the literature.

Methods

A multicenter retrospective study of 50 patients who underwent reversal of RYGB conducted between 2006 and 2015 was reviewed to describe the usual indications and outcomes of gastric bypass reversal surgeries.

Results

Of 50 patients, 7 (14 %) were males and 43 (86 %) were females. The mean age of the patient population was 40.4 ± 11.6 years (range 19–66). Reasons for reversal included anastomotic ulcers (n = 27), anastomotic complications (n = 9), malnutrition (n = 2), and functional disorder (n = 12). The mean BMI before the reversal was 29 ± 9.4 kg/m2 (range 16–60). The mean time between the primary procedure and reversal was 60 ± 65.5 months (range 2–300). Fourteen of the reversals were done via laparotomy. Mean hospital stay was 8.4 ± 7.3 days (range 3–34 days). There was no peri-operative death 30 days after reversal. Following gastric bypass reversal, 92.6 % (n = 25) of the patient population had resolution from ulcers, 77.8 % (n = 7) of the patient population had resolution from anatomic complications, 100 % (n = 2) of the patient population had resolution from malnutrition, and 66.7 % (n = 8) of the patient population had resolution from functional disorders.

Conclusions

Gastric bypass reversal is a reasonable and safe treatment for complications arising from the GBP surgery. A laparoscopic approach is feasible in select patients.

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Authors and Affiliations

  1. Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA

    Hinali Zaveri, Daniel Cottam, Amit Surve, Austin Cottam & Samuel Cottam

  2. Einstein Healthcare Network, 60 Township Line Road, Elkins Park, PA, 19027, USA

    Ramsey M. Dallal & Susan Kartiko

  3. Abington Memorial Hospital, 225 Newtown Rd, 2nd Flr-Main Bldg, Warminster, PA, 18974, USA

    Fernando Bonnani

Authors
  1. Hinali Zaveri
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  2. Ramsey M. Dallal
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  3. Daniel Cottam
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  4. Amit Surve
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  5. Susan Kartiko
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  7. Austin Cottam
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  8. Samuel Cottam
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Correspondence to Daniel Cottam.

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Conflict of Interest

Daniel Cottam, the corresponding author of this report, is part of the speaker bureau for Medtronic and has been awarded a research grant by Medtronic for the study of duodenal switch.

All the other authors declare that they have no competing interests.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Since this is a retrospective study, the formal consent is not required for this type of study.

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Zaveri, H., Dallal, R.M., Cottam, D. et al. Indications and Operative Outcomes of Gastric Bypass Reversal. OBES SURG 26, 2285–2290 (2016). https://doi.org/10.1007/s11695-016-2105-4

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  • DOI: https://doi.org/10.1007/s11695-016-2105-4

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