title: A functional Roux-en-Y gastric bypass to avoid gastric exclusion: 1-year results.
abstract: BACKGROUND
  Roux-en-Y gastric bypass (RYGBP) is rarely performed in Italy because it involves gastric exclusion. RYGBP with the stomach partitioned by an adjustable gastric band has been previously described. We have developed a functional RYGBP (FRYGBP) where an adjustable band allows access from a stapled gastric bypass pouch into the distal stomach.
  
  
  METHODS
  From October 2001 to May 2002, 16 patients underwent FRYGBP. A 30-cc vertical gastric pouch was fashioned by a 25-mm circular and 90-mm four-row stapler as in the Mason VBG. A hand-sewn retrocolic gastroenterostomy with 150-cm Roux and 30-cm afferent limbs completed the operation. The pouch outlet was encircled distal to the gastrojejunostomy by a non-inflated adjustable gastric band. The bands were inflated at 1 month during barium swallow, to demonstrate occlusion of the gastro-gastric outlet and patency of the gastrojejunostomy.
  
  
  RESULTS
  There was no operative mortality. After 1 year, mean percent excess BMI loss (%EBMIL) was 71.2 +/- 16.2% (SD), and gastroscopy of the bypassed stomach was possible on 81% of the patients. There were three asymptomatic late complications (19%): two band erosions, converted to RYGBP, and one stenosis of the gastro-gastric outlet.
  
  
  CONCLUSIONS
  FRYGBP thus far has been effective and allows the study of the excluded stomach. This ongoing study will undergo long-term evaluation.
authors: Dipartimento di Scienze Chirurgiche ed Anestesiologiche, Centro Studi di Terapia Chirurgica dell'Obesità Patologica, Università degli Studi di Bologna, Italy. stefanocariani@hotmail.com
authors: Stefano
authors: S
authors: Cariani
authors: Giovanni
authors: G
authors: Vittimberga
authors: Sergio
authors: S
authors: Grani
authors: Andrea
authors: A
authors: Lucchi
authors: Manuela
authors: M
authors: Guerra
authors: Enrico
authors: E
authors: Amenta
mesh_terms: D000713:Anastomosis, Roux-en-Y; D016099:Endoscopy, Gastrointestinal; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D011859:Radiography; D013272:Stomach Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome