title: Laparoscopic reversal of Roux-en-Y gastric bypass into normal anatomy with or without sleeve gastrectomy.
abstract: OBJECTIVE
  This study was designed to describe and analyze the outcomes after laparoscopic reversal to normal anatomy (NA) with or without concomitant "sleeve gastrectomy" (SG), after Roux-en-Y gastric bypass (RYGB). Reversal has been proposed as corrective strategy after RYGB.
  
  
  METHODS
  We propose a retrospective analysis of a prospectively kept database.
  
  
  RESULTS
  From January 2005 to October 2012, 20 female patients underwent laparoscopic reversal after RYGB for one or more of the following conditions: hypoglycaemic syndrome (nine patients), weight regain (six patients), severe dumping (six patients), and cachexia (two patients). Preoperative BMI was 28.0 (19.2-40.3) kg/m². Reversal was performed to NA in ten patients and included a SG procedure in another ten. Postoperative complications included one bleeding and three leaks (15%; all in SG patients). Mean hospital stay was 7 days. Mortality was 0. With a mean follow-up of 11.5 months, all but one patient recovered from their initial condition. However, three developed severe gastroesophageal reflux disease (GERD) symptoms and three had chronic diarrhoea.
  
  
  CONCLUSIONS
  Outcomes of laparoscopic reversal of RYGB are good, but complications may occur when SG is added. The surgical alterations caused by the reversal may explain the GERD or diarrhoea experienced by some patients.
authors.affiliation: Division of Bariatric Surgery, AZ St-Blasius, Kroonveldlaan 50, 9200, Dendermonde, Belgium, vilallongapuy@hotmail.com.
authors.forename: Ramon
authors.initials: R
authors.lastname: Vilallonga
authors.forename: Simon
authors.initials: S
authors.lastname: van de Vrande
authors.forename: Jacques
authors.initials: J
authors.lastname: Himpens
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013270:Stomach / Q000033:anatomy & histology*; D016896:Treatment Outcome; D055815:Young Adult