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.
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Various surgical re-interventions have been used, including gastric tube placement, gastric bypass reversal with or without concomitant sleeve resection and gastric pouch restriction.
“Various surgical re-interventions have been used, including gastric tube placement, gastric bypass reversal with or without concomitant sleeve resection and gastric pouch restriction (Table 5) (66,103,105-123).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [108]
Approximately 24% of patients who underwent surgical re-intervention because of refractory severe post-Roux-en-Y gastric bypass hypoglycemia received a gastric bypass reversal and approximately 9% had gastric pouch restriction.
“As shown in Table 5, approximately 24% of patients who underwent surgical re-intervention because of refractory severe post-Roux-en-Y gastric bypass hypoglycemia received a gastric bypass reversal (66,103,106-113) and approximately 9% had gastric pouch restriction (66,114,115).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [108]
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“El trabajo de Villalonga (9) incluyó 20 pacientes con revisión a anatomía normal tras el BGYR por distintas complicaciones, siendo en 9 por hipoglucemia refractaria, con resolución total de los síntomas.”
BackgroundHypoglycemia After Gastric Bypass
Alvarez, G. D. C. (2020) · Gastric Bypass · doi:10.1007/978-3-030-28803-7_35
Early and Late Dumping Syndromes
Mattar, S., & Rogers, A. (2019) · The ASMBS Textbook of Bariatric Surgery · doi:10.1007/978-3-030-27021-6_23
Revisional Surgical Options After Laparoscopic Roux-en-Y Gastric Bypass
Palanivelu, P., & Kumar, S. S. (2017) · doi:10.1007/978-981-10-2705-5_31
Revisional Surgery after LRYGB
Higa, K. D., & Chang, S. (2016) · doi:10.1007/978-3-319-04343-2_40
- Authors
- Vilallonga, R., van de Vrande, S., & Himpens, J.
- Affiliations
- AZ Sint-Blasius (BE)
- ORCID
- Himpens, Jacques
- Venue
- Surgical Endoscopy
- Published
- 2013-07-17
- Volume
- 27
- Issue
- 12
- Pages
- 4640-4648
- ISSN
- 0930-2794 (ISSN-L)
- 1432-2218
- OpenAlex
- W2028013792
- Cited by
- 85
- References
- 0
- Citations by year
- 2025: 6 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 11 · 2018: 3 · 2017: 5 · 2016: 20 · 2015: 6 · 2014: 11
- FWCI
- 12.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Surgical Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- Roux-en-Y gastric bypass, sleeve gastrectomy, laparoscopic surgery, weight regain, dumping syndrome, gastroesophageal reflux disease, chronic diarrhea, postoperative complications, bariatric surgery outcomes
- MeSH terms
- Adult, Female, Follow-Up Studies, Gastrectomy, Humans, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Complications, Retrospective Studies, Stomach, Gastric Bypass, Treatment Outcome, Young Adult
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