Gastric pouch resizing for Roux-en-Y gastric bypass failure in patients with a dilated pouch.
BACKGROUND
Insufficient weight loss or weight regain a few years after laparoscopic Roux-en-Y gastric bypass is becoming a serious problem given the large diffusion of this procedure. In the present study, we analyzed the feasibility and safety of pouch resizing for Roux-en-Y gastric bypass failure in a consecutive series of 20 patients at a university hospital.


METHODS
A prospectively maintained database was queried regarding patient demographics, the indication for revision morbidity, the percentage of excess weight loss, and the evolution of co-morbidities.


RESULTS
A total of 20 patients, 18 women and 2 men, with a mean age of 44 years and mean body mass index of 45.8 kg/m(2), underwent pouch resizing. No patients died; 6 patients (30%) developed complications, including acute abdomen due to volvulus of the small bowel in 1, intra-abdominal abscess in 3, and pulmonary embolus in 2. At a mean follow-up of 20 months, the percentage of excess weight loss was an average of 69.1% and persistent co-morbidities had improved or resolved.


CONCLUSIONS
Pouch resizing has been shown to be a valuable option in the short term for weight loss failure or regain in patients who have undergone laparoscopic Roux-en-Y gastric bypass and have a dilated gastric pouch. However, the long-term efficacy of this procedure needs to be determined.
Centre Hospitalier Universitaire de Nice, Pôle digestif, Nice, France. antonio_iannelli@hotmail.com
Antonio
A
Iannelli
Anne-Sophie
AS
Schneck
Xavier
X
Hébuterne
Jean
J
Gugenheim
D000328:Adult; D004108:Dilatation, Pathologic / Q000209:etiology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012086:Reoperation; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D017211:Treatment Failure; D015431:Weight Loss / Q000502:physiology*