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Medium-Term Outcomes after Reversal of Roux-en-Y Gastric Bypass
Gustavo Andrés Arman1, J Himpens2, R Bolckmans2
1Division of Bariatric Surgery, AZ Sint-Blasius, Kroonveldlaan 50, 9200, Dendermonde, Belgium. gusarman@hotmail.com.
Obesity Surgery
|September 21, 2017
Summary
Roux-en-Y gastric bypass reversal effectively treats side effects like dumping syndrome and malnutrition. However, pre-reversal gastrostomy and hiatal hernia repair may increase complications and new-onset GERD.
Area of Science:
- Bariatric surgery
- Gastrointestinal surgery
- Surgical outcomes
Background:
- Roux-en-Y gastric bypass (RYGB) reversal can restore normal anatomy (NA) or create sleeve gastrectomy (NASG).
- Hiatal hernia repair (HHR) may be performed concurrently.
- Gastrostomy placement prior to reversal can help predict outcomes.
Purpose of the Study:
- To evaluate the mid-term effects of RYGB reversal to NA and NASG.
- To assess clinical outcomes, weight changes, complications, and GERD incidence post-reversal.
Main Methods:
- Retrospective study of 25 patients undergoing RYGB reversal.
- Analysis of clinical data, weight evolution, surgical complications, and GERD.
- Follow-up duration averaged 5.3 years.
Main Results:
- Reversal successfully resolved dumping syndrome, malnutrition, diarrhea, and nausea/vomiting.
- Hypoglycemic syndrome resolved in 75% of cases.
- Normal anatomy reversal led to significant weight regain, while NASG resulted in some weight loss. Complications occurred in 5/7 patients with pre-reversal gastrostomy. De novo GERD developed in 57.1% of patients despite HHR.
Conclusions:
- RYGB reversal is effective for managing adverse effects.
- Pre-reversal gastrostomy may increase complication risk.
- Concomitant HHR might be associated with de novo GERD development.
