PROPOSAL OF A REVISIONAL SURGERY TO TREAT SEVERE NUTRITIONAL DEFICIENCY POST-GASTRIC BYPASS

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Nutritional Science

Background:

• Gastric bypass surgery is associated with a 17% rate of nutritional and electrolyte disturbances.
• Common deficiencies include protein, iron, zinc, and vitamins, with rare cases requiring hospitalization or revision surgery.

Purpose of the Study:

• To propose a surgical revision technique for managing severe malnutrition post-bariatric surgery.
• To address the need for effective treatment options for post-bariatric malnutrition.

Main Methods:

• The surgical revision reconstitutes food transit through the duodenum and proximal jejunum.
• It maintains the restrictive component of the gastric bypass.
• Gastric fundus resection is performed to enhance ghrelin suppression and prevent excessive weight regain.

Main Results:

• The procedure was successfully performed on two patients as a definitive treatment for severe malnutrition.
• Initial stabilization included nutritional and electrolyte support.
• Positive outcomes were observed at the one-year follow-up.

Conclusions:

• Surgical therapy is a viable option for improving or resolving nutritional deficits after bariatric surgery.
• The proposed technique, based on pathophysiological factors, shows good initial results without significant adverse effects.
• Further long-term follow-up is necessary to establish the definitive efficacy of this surgical approach.