title: Prospective sequential endoscopic and histologic studies of the gastric pouch in 130 morbidly obese patients submitted to Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Roux-en-Y gastric bypass is the most common performed bariatric surgery. A small gastric pouch is created, leaving a narrow gastrojejunal anastomosis, with a long jejunal limb. Very little is known regarding the behavior of this pouch years after surgery.
  
  
  OBJECTIVE
  To determine through prospective sequential endoscopic studies the size of the gastric pouch, the diameter of the anastomosis, and the behavior of H. pylori infection after surgery.
  
  
  METHODS
  In 130 patients subjected to resectional gastric bypass, several routine sequential endoscopic (until 120 months) and histological evaluations of the gastric pouch were performed.
  
  
  RESULTS
  After surgery, a mean of 3.6 endoscopies/patient were performed. Macroscopically nearly 95% of the small gastric pouches were normal, and the main pathological finding was a marginal ulcer. Erosive esophagitis disappeared in 93% of the patients. There was no increase in the orocaudal size of the pouch during this period of observation. There was no dilatation of the diameter of gastrojejunal anastomosis. Near 54% of all patients had normal fundic mucosa, while 18% had chronic active gastritis, coincident with H. pylori infection. Five patients had intestinal metaplasia.
  
  
  CONCLUSIONS
  Based on this sequential endoscopic evaluation, there was no increase in the orocaudal size of the gastric pouch nor increase in the diameter of the gastrojejunal anastomosis. H. pylori behavior was inconsistent and difficult to interpret.
authors: Departamento de Cirurgia e Patologia, Hospital Universitário, Santiago, Chile. acsendes@redclinicauchile.cl
authors: Attila
authors: A
authors: Csendes
authors: Gladys
authors: G
authors: Smok
authors: Ana Maria
authors: AM
authors: Burgos
authors: Moira
authors: M
authors: Canobra
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015390:Gastric Bypass; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D013270:Stomach / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult