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Roux-en-Y Gastric Bypass Study Issues
- Roux-en-Y gastric bypass (RY-GBP) has a very small gastric pouch with
a 1-cm diameter Roux-Y gastrojejunostomy.
- RY-GBP is associated with early satiety and an aversion to sweets
secondary to dumping syndrome symptoms and has a significantly better
weight loss than various gastroplasty procedures, including the vertical
banded gastroplasty.
- However, it may be associated with vitamin B-12 deficiency and iron
deficiency anemia in menstruating females, preventable with prophylactic
oral iron and vitamin B-12.
- RY- GBP patients lose two-thirds of their excess weight within 2 years,
60% at 5 years, and greater than 50%
at 9 years.
- The RY-GBP can be beaten by nibbling "junk foods" (potato
or corn chips).
- Conversion to a malabsorptive procedure may cause severe malnutrition
and fat-soluble vitamin deficiencies and should be used only for "superobese"
patients who fail a standard RY-GBP and have severe comorbidity.
- RY-GBP is the most effective procedure for morbid obesity, especially
in patients addicted to "sweets."
Authors:
HJ Sugerman, JM Kellum, KM Engle, L Wolfe, JV Starkey, R Birkenhauer,
P Fletcher and MJ Sawyer. Department of Surgery, Medical College of Virginia,
Richmond 23298.
Source:
American Journal of Clinical Nutrition
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