Details

Autor(en) / Beteiligte

• Pucher, Philip H., PhD MRCS
• Lord, Amy C., MRCS
• Sodergren, Mikael H., PhD MRCS
• Ahmed, Ahmed R., FRCS
• Darzi, Ara, KBE PC FRCS
• Purkayastha, Sanjay, MD FRCS

Titel

Reversal to Normal Anatomy Following Failed Gastric Bypass: Systematic Review of Indications, Techniques, and Outcomes

Ist Teil von

• Surgery for obesity and related diseases, 2016

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Abstract Background Roux-en-Y gastric bypass (RYGB) is one of the most common, and most effective, procedures performed to combat obesity and obesity-related metabolic disease. In a small proportion of patients, however, complications may necessitate the attempted reversal of RYGB to normal anatomy. The indications for this procedure, as well as technique, complication rate, and success in resolving symptoms are not clearly defined. Objective To assess current literature describing outcomes following reversal of RYGB. Methods A systematic search of online databases was conducted. Two independent researchers identified and extracted data for studies describing outcomes following RYGB reversal surgery. Indications, techniques, and outcomes were compared, with results pooled where possible. Results Eight articles were included in the final data synthesis, incorporating data for 46 patients. Reversal was undertaken due to metabolic, physical, nutritional, or other complications. All successfully underwent RYGB reversal with no reported mortality. Surgical technique varied greatly across the included studies. Postoperative morbidity was high, with 42% suffering complications (56% of which were major complications). Symptom relief or improvement was achieved in 82% of cases. Conclusion Reversal of RYGB may be undertaken for a variety of indications following RYGB. Though this may successfully eliminate or improve symptoms in a large proportion of patients, the risk of morbidity is high. Surgery should be undertaken following careful patient selection and in appropriately skilled centres only.