An Analysis of 37 Reversals on 504 Biliopancreatic Surgeries over 12 Years.
Of 504 biliopancreatic diversions, 37 patients (7%) had to be reversed. There were many underlying causes for the nutritional compromise that preceded each reversal, but nearly two-thirds were due to either the nausea/ hyperemesis syndrome or to protein malnutrition and anemia. Poor patient compliance with respect to supplements was a major contributory factor. The procedure can be reversed by either a proximal enteroenterostomy or restoration of anatomical continuity. The simpler enteroenterostomy, the method of choice, was done in 70% of the cases. There are specific indications for the more complex anatomical restoration. Reversals have proved to be successful in correcting the nutritional defects.
Clare
WM
Goleta Valley Community Hospital, Santa Barbara, CA, 93111 USA.