Gastroesophageal Reflux after Intact Vertical Banded Gastroplasty: Correction by Conversion to Roux-en-Y Gastric Bypass

Bruno M. Balsiger, Michel M. Murr, Jane Mai, Michael G. Sarr

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

Symptomatic gastroesophageal reflux disease is common in our experience after vertical banded gastroplasty. Our aim was to determine the safety and efficacy of Roux-en-Y gastric bypass in the treatment of symptomatic gastroesophageal reflux disease complicating vertical banded gastroplasty. We evaluated prospectively collected data on 25 patients who underwent revisional bariatric surgery because of severe gastroesophageal reflux disease after vertical banded gastroplasty. Only 4 of 25 patients had gastroesophageal reflux disease symptoms prior to vertical banded gastroplasty. Endoscopic findings in 24 patients included esophagitis (58%), Barrett's esophagus (28%), pouchitis (29%), and gastritis (21%); 7 (28%) of 25 patients had evidence of stenosis at the pouch outlet. Mean follow-up (complete in all 25) after Roux-en-Y gastric bypass was 37 ± 7 months (range 3 to 102 months). There were no deaths. Postoperative complications occurred in six patients: pneumonia in two, wound infection in two, prolonged drainage of the defunctionalized stomach via gastrostomy in one, and fever in one. Median hospitalization was 7 days (range 5 to 43 days). At follow-up (37 ± 7 months), 24 (96%) of 25 are completely or almost completely symptom free. Body mass index was 33 ± 2 kg/m2 before and 28 ± 2 kg/m2 after Rouxen-Y gastric bypass (P = 0.001). Symptoms of gastroesophageal reflux disease are common after vertical banded gastroplasty. Conversion to Roux-en-Y gastric bypass is safe, relieves gastroesophageal reflux disease, and promotes further weight loss. Moreover, maladaptive eating (vomiting, and so forth) induced by vertical banded gastroplasty is relieved.

Original languageEnglish (US)
Pages (from-to)276-281
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume4
Issue number3
StatePublished - May 2000

    Fingerprint

Keywords

  • Bariatric surgery
  • Gastroesophageal reflux
  • Obesity
  • Roux-en-Y gastric bypass
  • Vertical banded gastroplasty

ASJC Scopus subject areas

  • Surgery

Cite this