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Roux-en-Y Gastric Bypass to Treat Gastroesophageal Reflux After VBG

Case Study of Vertical Banded Gastroplasty to Roux-en-Y

Weight Loss Surgery Operations - Research Into Gastric Reduction Surgery

Conversion From Vertical Banded Gastroplasty to Roux-en-Y Gastric Bypass to Treat Complication of Persistent Gastroesophageal Reflux Disease: A Case Study

Vertical banded gastroplasty (VBG) is sometimes associated with gastroesophageal reflux disease (GERD) and long-time failure in weight loss. This situation is a problem; one therapeutic option is a Roux-en-Y gastric bypass (RYGBP). The study objective was to analyze the perspective of laparoscopic surgical treatment in a patient with persistent GERD after traditional bariatric surgery for morbid obesity management.

Case Report

A 48-year-old woman with morbid obesity, body mass index (BMI) of 46 kg/m(2), and high blood pressure underwent vertical banded gastroplasty (open surgery, Mason's technique) in 1996 and decreased her BMI to 32 kg/m(2). Six years after initial surgery, she developed severe GERD resistant to medical treatment (omeprazol 80 mg/day) that was confirmed by 24-h esophageal pH monitoring (48 DeMeester normal) and esophageal manometry (low esophageal sphincter pressure) 5 mmHg). During these years, she increased BMI from 32 kg/m(2) to 40 kg/m(2). Laparoscopic conversion to Roux-en-Y gastric bypass was performed.

Results

Post-operative evolution was satisfactory with disappearance of GERD. Control 24-h esophageal pH monitoring reported 4 DeMeester normal. At 12-month follow-up, she decreased BMI to 27 kg/m(2).

Conclusions

Laparoscopic reoperative Roux-en-Y gastric bypass is a viable surgical option in GERD treatment and obesity control.

Authors:
Moreno-Portillo M, Pereira-Graterol F, Magos FJ, Rojano-Rodriguez M, Alvarado-Aparicio A, Palacios-Ruiz JA. Hospital General "Dr. Manuel Gea Gonzalez," Division de Cirugia Endoscopica, sexto piso, Oficina de Invasion Minima, Calzada de Tlalpan 4800, Col Toriello Guerra, Tlalpan 14000 Mexico D.F., Mexico.

Source:
National Library of Medicine

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2008 Bariatric-Surgery.Info - Terms - Contact - Information - Resources - Add URL