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.
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.
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 %.
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
