Laparoscopic reversal of Roux-en-Y gastric bypass into normal anatomy with or without sleeve gastrectomy

Abstract

Outcomes of laparoscopic reversal of RYGB are good, but complications may occur when SG is added. The surgical alterations caused by the reversal may explain the GERD or diarrhoea experienced by some patients.

Hypoglycemia after Roux-En-Y gastric bypass: detection rates of continuous glucose monitoring (CGM) versus mixed meal test

“…A much larger number of patients might suffer from vague symptoms and are therefore not being diagnosed with post-gastric bypass hypoglycemia. Subsequently, they are not offered adequate treatment, which might consist of dietary modifications [18,28], acarbose [29][30][31], octreotide [15,32], verapamil [33] or diazoxide [34] as drug therapy or surgical interventions such as secondary bypass banding [35,36], bypass reversal [37,38] or pancreatic resection [24][25][26][27]39]. In our study, CGM provided better detection rates for post-RYGB hypoglycemia compared with MMT.…”

Dumpingsyndrom etter kirurgi på magesekken

“…Gastrisk bypass har vaert reversert til «vanlig» anatomi, og etter ventrikkelreseksjon har man konvertert til alternative former for gastrointestinal rekonstruksjon (12,32). I behandlingen av refraktaer hypoglykemi har pancreasreseksjon vaert benyttet (13).…”

Conversion from gastric bypass to sleeve gastrectomy for complications of gastric bypass

“…In 2013, Zurita reported 2 patients with resolution of intractable dumping syndrome following conversion to SG (8) . Also in 2013, Vilallonga et al described 10 patients who underwent conversion to SG and 10 who underwent reversal to normal anatomy for a variety of indications (7) . Finally, Campos et al described 3 patients converted to SG and 2 reversed to normal anatomy, all with resolution of hyperinsulinemic hypoglycemia or severe hypocalcemia following inadvertent parathyroidectomy after RYGB (9) .…”

“…Such a procedure has been described for correction of retrograde intussusception (5) , weight regain (6,7) , intractable dumping syndrome (8) , cachexia (7) , severe neuroglycopenia (7,9) , and hypocalcemia following inadvertent parathyroidectomy (9) . Currently, there are 5 series in the literature describing a total of 27 patients who have undergone conversion from RYGB to SG.…”