Revision using totally hand-sewn gastrojejunostomy and truncal vagotomy for refractory marginal ulcer after laparoscopic Roux-en-y gastric bypass: a case series.
Surg Obes Relat Dis
; 13(4): 588-593, 2017 Apr.
Article
en En
| MEDLINE
| ID: mdl-28215394
ABSTRACT
BACKGROUND:
Marginal ulcer (MU) is not infrequent after laparoscopic Roux-en-Y gastric bypass (LRYGB). Medication plus lifestyle modification remains the mainstay solution. Patients with refractory MU may be candidates for revisional surgery.OBJECTIVE:
To summarize our experience of revisional surgery for treating refractory MU after LRYGB.SETTING:
University hospital, Taiwan.METHODS:
A retrospective analysis was performed for 11 patients with refractory MU undergoing totally hand-sewn gastrojejunostomy and truncal vagotomy at our institution between August 2005 and May 2015. The mean follow-up after surgery was 28.0±16.2 months (range, 10-48 mo); 9 patients (81.8%) were followed up more than 1 year after.RESULTS:
The mean age of the cohort (7 males; 4 females) was 39.5±16.0 years (range, 19-66 yr), with a mean initial body mass index of 37.5±9.3 kg/m2 (range, 32.1-57 kg/m2). Intractability was the dominant manifestation (100%); 8 patients (72%) had stricture at the gastrojejunostomy. The mean interval from initial LRYGB to refractory MU and revisional surgery was 10.2±7.7 months (range, 4-28 mo) and 38.7±21.6 months (range, 10-67 mo), respectively. The average operation time was 150.4±59.8 minutes (range, 80-300 min), and the average length of hospital stay was 4.2±1.4 days (range, 2-7 d). The 9 patients with more than 1 year follow-up all achieved endoscopic resolution of the refractory MU.CONCLUSIONS:
Although longer follow-up is warranted, revisional surgery with totally hand-sewn gastrojejunostomy and truncal vagotomy can be an effective solution for refractory MU.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Úlcera Péptica
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Complicaciones Posoperatorias
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Obesidad Mórbida
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Derivación Gástrica
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Vagotomía Troncal
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Técnicas de Sutura
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Laparoscopía
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Surg Obes Relat Dis
Asunto de la revista:
METABOLISMO
Año:
2017
Tipo del documento:
Article