title: [Gastric bypass Roux-en-Y gastrojejunostomy--conversion to distal gastrojejunoileostomy for weight loss failure--experience in 41 patients].
abstract: BACKGROUND
  Surgery is the only effective treatment for morbid obesity. Gastric bypass could fail in up to 10% of the patients (excess weight loss under 50%).
  
  
  OBJECTIVE
  To evaluate the weight loss determined by reoperation performing disabsortive variation of gastric bypass.
  
  
  METHODS
  The records of 41 patients, in whom 32 were submitted to reoperation by one of three surgical techniques (Fobi, Brolin, distal gastrojejunoileal bypass) which consisted in increasing the disabsortive length of intestinal limb.
  
  
  RESULTS
  The patients submitted to distal gastrojejunoileal bypass showed the best results (69.7%).
  
  
  CONCLUSIONS
  The distal gastric bypass as a revisional procedure could be done in selected cases with the aim to improve the weight loss. It is advisable to refer these patients to selected centers (known as center of excellence) with experience in this area of bariatric surgery, in order to perform a very close follow-up.
authors.affiliation: Grupo de Cirurgia de Obesidade, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP. jcpareja@obesidadesevera.com.br
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pareja
authors.forename: Victor Fernando
authors.initials: VF
authors.lastname: Pilla
authors.forename: Francisco
authors.initials: F
authors.lastname: Callejas-Neto
authors.forename: João de Souza
authors.initials: Jde S
authors.lastname: Coelho-Neto
authors.forename: Elinton Adami
authors.initials: EA
authors.lastname: Chaim
authors.forename: Daniéla Oliveira
authors.initials: DO
authors.lastname: Magro
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure