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Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty

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Abstract

Background

The aims of this study are to evaluate the macroscopic and microscopic changes in the remnant stomach at mid-term follow-up of patients who underwent a Roux-en-Y gastric bypass on vertical banded gastroplasty (RYGB-on-VBG). The stomach could be reached through a 1.1-cm gastro-gastrostomy with an endoscope of standard size.

Methods

From January 2009 to July 2010, 51 asymptomatic patients at 4 and 5 years follow-up after RYGB-on-VBG submitted to upper endoscopy. All of them were examined with standard endoscopy with collection of biopsies in gastric fundus, body, and antrum. The macroscopic and microscopic findings were analyzed according to Sydney Classification.

Results

The endoscopy of the remnant stomach was technically easy and already showed on macroscopic examination 90 % cases of gastritis (41.2 % mild, 49 % severe) with tendency of severity in the distal stomach part. Histological analysis detected 39.2 % of active gastritis, 50.6 % of quiescent gastritis, 7.8 % of intestinal metaplasia, and 3.9 % of lymphoma-like gastritis.

Conclusions

The results surprised us. We found a very high rate of mucosa abnormalities after RYGB-on-VBG. All of the patients have to be regularly controlled in follow-up and treatment has to be introduced when needed. Again, we would like to ask the question: what is happening with the remnant stomach after standard RYGB, banded gastric bapass, or minigastric bypass? Did we reach the time to answer the question?

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Conflict of Interest

Dr. Luca Leuratti, Dr. Massimo Pierluigi Di Simone, and Dr. Stefano Cariani have no financial or other conflicts of interest to disclose.

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Authors and Affiliations

  1. Obesity Surgery Center, Department of Emergency-Urgency, General Surgery and Transplantation, University of Bologna, Bologna, Italy

    Luca Leuratti & Stefano Cariani

  2. Surgical Endoscopy Unit, Department of Emergency-Urgency, General Surgery and Transplantation, University of Bologna, Bologna, Italy

    Massimo Pierluigi Di Simone

  3. Via Massarenti 9, 40138, Bologna, Italy

    Luca Leuratti

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  1. Luca Leuratti
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Correspondence to Luca Leuratti.

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Leuratti, L., Di Simone, M.P. & Cariani, S. Unexpected Changes in the Gastric Remnant in Asymptomatic Patients after Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty. OBES SURG 23, 131–139 (2013). https://doi.org/10.1007/s11695-012-0808-8

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