Remedial surgery following failed gastroplasty for morbid obesity.
Gastroplasty (GP) or gastric bypass with exclusion of 90% of the distal stomach ( GBP) have largely replaced small bowel bypass in the surgical management of morbid obesity. Despite the theoretical advantages of GP over GBP, revision rates of up to 20% are reported with GP because of unsatisfactory weight loss resulting from staple line disruption, pouch dilatation, and/or stomal enlargement. This report describes four alternative surgical approaches to failed GP. "Complete" partitioning of the stomach accompanied by gastrogastrostomy or conversion to Roux-en-Y GBP is recommended. Because of intangible advantages associated with exclusion of the stomach and duodenum, conversion to GBP is favored over GP revision in such cases.[1]References
- Remedial surgery following failed gastroplasty for morbid obesity. Eckhauser, F.E., Knol, J.A., Strodel, W.E. Ann. Surg. (1983) [Pubmed]
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