Critical determinants of a successful gastric bypass: reservoir versus stoma.
Most investigators have emphasized that both a small reservoir and a narrow stoma are critical to the success of a gastric bypass. This prospective study was performed to test this clinical hypothesis. All patients had a similar 30-45 ml proximal gastric reservoir created; however, stoma size was determined by the lumen of the jejunum, averaging 3.2 cm in cross-sectional diameter. We found that stoma size had little effect on the success of the gastric bypass if a tiny (less than 45 ml) reservoir was consistently created and a Roux-en-Y anastomosis was used for reestablishing intestinal continuity. The avoidance of a small stoma virtually eliminates postbypass emesis as a major complication.
D000328:Adult; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008722:Methods; D009765:Obesity / Q000628:therapy*; D011446:Prospective Studies; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D014839:Vomiting / Q000209:etiology