Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
AbstractThis video shows the case of a 64-year-old morbidly obese woman, with a non-adjustable gastric band, who consulted for weight regain and gastroesophageal reflux disease (GERD) symptoms and was converted to Roux-en-Y gastric bypass (RYGB). The operative technique included extensive lysis of adhesions, complete band dissection, partial gastrectomy of the fundus and body due to band erosion and conversion to RYGB.
Bariatric surgery is a proven, efficacious, and durable treatment for obesity and weight-related diseases. In addition to other metabolic effects, surgery can have both a positive and negative clinical impact on GERD. The spectrum of surgical procedures currently offered have varying degrees of improvement or worsening of pre-existing symptoms or development of new symptoms. Of the most commonly performed bariatric procedures, Roux en-Y gastric bypass has been shown to be highly effective in treatment of GERD1, likely through a combination of weight loss and subsequent decrease of intra-abdominal pressure, as well as separ...
Conclusion: GERD may improve in obese patients who underwent laparoscopic sleeve gastrectomy (LSG); however, the most favorable effect is likely to be found after Roux-en-Y gastric bypass surgery. Prospero registration number: CRD42018090074.
Obesity is well known to increase the risk of gastroesophageal reflux disease (GERD). The impact of sleeve gastrectomy (SG) on GERD is still discussed but seems to be associated with the development of de novo GERD or the exacerbation of preexisting GERD.
ConclusionsForegut pathology is common in bariatric patients with subjective symptoms of GERD. Implementing a comprehensive protocol to objectively assess these patients leads to a significant clinical impact on which procedure these patients ultimately undergo.
This study included patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). The primary outcome of interest was incisional SSI occurring within 30 days. Surgeries performed in 2015 were used in a derivation cohort and the predictive tool was validated against the 2016 cohort. A forward selection algorithm was used to build a logistic regression model predicting probability of SSI.ResultsA total of 274,187 patients were included with 71.7% being LSG and 28.3% LRYGB. 0.7% of patients had a SSI in which 71.0% had an incisional SSI, and 29.9% had an organ/spa...
One-anastomosis gastric bypass (OAGB) is an accepted bariatric and metabolic surgery with certain important complications, such as postoperative gastroesophageal reflux disease (GERD) and bile reflux (BR), which are not well addressed in literature.
One anastomosis gastric bypass (OAGB) is an accepted bariatric and metabolic surgery with certain important complications such as post-operative gastroesophageal reflux disease (GERD) and bile reflux (BR), which are not well addressed in literature.
Sandeep Aggarwal, Amit Bhambri, Vitish Singla, Nihar Ranjan Dash, Atul SharmaJournal of Minimal Access Surgery 2020 16(2):175-178Mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) is an emerging weight loss surgical procedure. There are serious concerns not only regarding the symptomatic biliary reflux into the stomach and the oesophagus but also the increased risk of malignancy after MGB/OAGB. A 54-year-old male, with a body mass index (BMI) of 46.1 kg/m2, underwent Robotic MGB at another centre on 22nd June 2016. His pre-operative upper gastrointestinal endoscopy was not done. He lost 58 kg within 18 months af...
ConclusionA tailored HIDA scan protocol with addition of a SPECT-CT scan, ingestion of a fatty meal and prolonged scanning duration results in enhanced bile reflux detection in post-bariatric surgical patients.