[Conversion to laparoscopic Roux-en-Y gastric bypass after vertical banded gastroplasty. A case report].
BACKGROUND
Vertical banded gastroplasty (VBG) is sometimes associated with gastroesophageal reflux disease (GERD) and long-time failure in weight loss. This situation is a problem; one therapeutic option is a Roux-en-Y gastric bypass (RYGBP).


OBJECTIVE
To analyze the perspective of laparoscopic surgical treatment in a patient with persistent GERD after traditional bariatric surgery for morbid obesity management.


METHODS
A 48-year-old woman with morbid obesity, body mass index (BMI) of 46 kg/m(2), and high blood pressure underwent VBG (open surgery, Mason's technique) in 1996 and decreased her BMI to 32 kg/m(2). Six years after initial surgery, she developed severe GERD resistant to medical treatment (omeprazol 80 mg/day) that was confirmed by 24-h esophageal pH monitoring (48 DeMeester normal) and esophageal manometry (low esophageal sphincter pressure) 5 mmHg). During these years, she increased BMI from 32 kg/m(2) to 40 kg/m(2). Laparoscopic conversion to RYGBP was performed.


RESULTS
Postoperative evolution was satisfactory with disappearance of GERD. Control 24-h esophageal pH monitoring reported 4 DeMeester normal. At 12-month follow-up, she decreased BMI to 27 kg/m(2).


CONCLUSIONS
Laparoscopic reoperative RYGBP is a viable surgical option in GERD treatment and obesity control.
Moreno-Portillo
Mucio
M
Hospital General "Dr. Manuel Gea González," División de Cirugía Endoscópica, sexto piso, Oficina de Invasión Mínima, Calzada de Tlalpan 4800, Col Toriello Guerra, Tlalpan 14000 México D.F., México. pfreddy@telcel.net.ve
Pereira-Graterol
Freddy
F
Magos
Francisco Javier
FJ
Rojano-Rodríguez
Martín
M
Alvarado-Aparicio
Aldo
A
Palacios-Ruíz
José Antonio
JA
D000713:Anastomosis, Roux-en-Y; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D015391:Gastroplasty; D006801:Humans; D006973:Hypertension / Q000150:complications; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D015430:Weight Gain