One-Anastomosis Gastric Bypass Revision for Gastroesophageal Reflux Disease: Long Versus Short Biliopancreatic Limb Roux-en-Y Gastric Bypass

被引：12

作者：

Tarhini, Ahmad ^{[1
,2
]}

Rives-Lange, Claire ^{[1
,3
]}

Jannot, Anne-Sophie ^{[1
,4
]}

Baratte, Clement ^{[1
,2
]}

Beaupel, Nathan ^{[1
]}

Guillet, Vincent ^{[1
,2
]}

Krivan, Sylvia ^{[5
]}

Le Gall, Maude ^{[1
,6
]}

Carette, Claire ^{[1
,3
]}

Czernichow, Sebastien ^{[1
,3
,7
]}

Chevallier, Jean-Marc ^{[1
,2
]}

Poghosyan, Tigran ^{[1
,2
,6
]}

机构：

[1] Univ Paris, F-75015 Paris, France

[2] Hop Europeen Georges Pompidou, Assistance Publ Hop Paris AP HP, Serv Chirurg Digest Oncol & Bariatr, Paris, France

[3] Hop Europeen Georges Pompidou, Assistance Publ Hop Paris AP HP, Serv Nutr, Ctr Specialise Obesite, Paris, France

[4] Hop Europeen Georges Pompidou, Assistance Publ Hop Paris AP HP, Serv Informat Med Biostat & Sante Publ, Paris, France

[5] Royal Derby Hosp, Dept Digest Surg, Derby, England

[6] INSERM, UMRS 1149, Paris, France

[7] INSERM, Informat Sci Support Personalized Med, Cordeliers Res Ctr, Paris, France

来源：

OBESITY SURGERY | 2022年 / 32卷 / 04期

关键词：

One-anastomosis gastric bypass; GERD; Roux-en-Y gastric bypass; Revisional surgery; COMPLICATIONS; OUTCOMES;

D O I：

10.1007/s11695-022-05892-6

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Purpose One-anastomosis gastric bypass (OAGB) may be associated with refractory gastroesophageal reflux disease (GERD). The nature of this GERD remains unclear. This complication can be treated either with an additional enteroenterostomy without shortening of gastric pouch (long biliopancreatic limb Roux-en-Y gastric bypass (L-BPL-RYGB)) or revision to conventional short biliopancreatic limb Roux-en-Y gastric bypass (S-BPL-RYGB). The objective of this study is to compare the aforementioned procedures in terms of efficacy on GERD symptoms. Materials and Methods Retrospective analysis between October 2012 and June 2020. Results Fifty-two patients underwent OAGB revision to S-BPL-RYGB (n = 21) or L-BPL-RYGB (n = 31) secondary to GERD. Investigation with pH impedance prior to revision was performed in 15 patients showing biliary reflux (BR) in 7 (46.6%), acid reflux (AR) in 6 (40%), and no confirmation in 2. Patients with AR had a revision to S-BPL-RYGB, whereas patients with BR underwent L-BPL-RYGB. Among the patients without pH metry results (n = 37), S-BPL-RYGB was performed for associated disabling digestive disorders or nutritional deficiencies. GERD was treated in 68% of patients with L-BPL-RYGB versus 95% of patients after S-BPL-RYGB. Patients, whose decision for revisional procedure was based on the results of pH impedance testing, did not reveal refractory GERD. Conclusion L-BPL-RYGB seems appropriate in patients with BR, whereas conversion to S-BPL-RYGB should be preferred if AR is present.

引用

页码：970 / 978

页数：9