Key result
Laparoscopic pouch resizing for inadequate weight loss after Roux-en-Y gastric bypass resulted in a median excess weight loss of 29.1% and a mean BMI reduction of 5.5 kg/m2 over a mean follow-up of 14.1 months.
Why the study?
Does laparoscopic pouch resizing improve weight loss in patients with inadequate weight loss after Roux-en-Y gastric bypass?
Cohort (n=32)
No
Does laparoscopic pouch resizing improve weight loss in patients with inadequate weight loss after Roux-en-Y gastric bypass?
Laparoscopic pouch resizing is a feasible and safe revisional procedure that can lead to adequate weight loss in patients with a dilated gastric pouch after Roux-en-Y gastric bypass.
LPR may be feasible for weight regain after RYGB; leaves open the need for prospective trials on efficacy and durability.
BACKGROUND: Weight regain due to gastric pouch dilatation after Roux-en-Y gastric bypass (RYGB) is seen more frequently after long-term follow-up. We studied the feasibility and safety of laparoscopic pouch resizing (LPR) for dilated gastric pouch after RYGB associated with inadequate weight loss. METHODS: From 1st June 2011 to 1st September 2013, patients who underwent LPR after failed RYGB were retrospectively compared and analyzed. Data included patient demographics, comorbidity, indication for revision, preoperative weight and BMI, operative time, hospital stay, conversion rate, mean follow-up, body mass index (BMI) loss, percentage excess weight loss (%EWL), reoperation rate, morbidity, and mortality. RESULTS: Out of 170 revisional bariatric procedures, 32 LPR (27/5, F/M) were performed for dilated gastric pouch after RYGB. The mean age, preoperative weight, and BMI were 38.3 ± 9.3 years, 101.7 ± 22.8 kg, 38.8 ± 6.4 kg/m(2), respectively. The median operative time and hospital stay were 100 min and 2 days, respectively. All pouch resizing procedures were carried out laparoscopically, with none requiring conversion to open surgery. The overall complication and reoperation rates were 15.6 and 3.1 %, respectively. There were no deaths. The mean follow-up was 14.1 ± 6.2 months. The mean postoperative BMI was 32.8 ± 7.3 kg/m(2), and the median %EWL was 29.1 %. CONCLUSIONS: LPR is safe and can lead to adequate weight loss. However, long-term follow-up is needed to determine the efficiency and durability of this procedure.
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Al‐Bader et al. (2015) conducted a cohort in Inadequate weight loss after Roux-en-Y gastric bypass (n=32). Laparoscopic pouch resizing was evaluated on Median percentage excess weight loss (%EWL). Laparoscopic pouch resizing for inadequate weight loss after Roux-en-Y gastric bypass resulted in a median excess weight loss of 29.1% and a mean BMI reduction of 5.5 kg/m2 over a mean follow-up of 14.1 months.
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