Document Detail


Gastroesophageal reflux after vertical banded gastroplasty is alleviated by conversion to gastric bypass.
MedLine Citation:
PMID:  22052197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Conversion operations after vertical banded gastroplasty (VBG) are sometimes performed because of vomiting and/or acid regurgitation. Primary operation with gastric bypass (GBP) is known to reduce gastroesophageal reflux (GERD). Previous studies have not been designed to differentiate between the effects of the altered anatomy and of the ensuing weight loss. No series has reported data on acid reflux before and after conversion from VBG to GBP.
METHODS: We invited eight VBG patients with current symptoms of GERD. All had intact staple lines as assessed by barium meal and gastroscopy. Acid reflux was quantified using 48-h Bravo capsule measurements. Conversion operations were performed creating an isolated 15-20-ml pouch; the previously banded part of gastric wall was excised. Gastrojejunostomy was made end to end with a 28-mm circular stapler. The study is based on five patients consenting to early postoperative endoscopy and pH measurement.
RESULTS: All patients were women with a mean age of 49.5 years and BMI of 36.3. Time since VBG was 132.1 months. Time from conversion to second measurement was 46.6 days and BMI at that time 32.7. There was no mortality and no serious morbidity. All patients improved clinically and no patient had to go back on proton pump inhibition or antacids. Total time with pH < 4.0 was reduced from 18.4% to 3.3% (p < 0.05). DeMeester score was reduced from 58.1 to 15.9 (p < 0.05).
CONCLUSIONS: The effect of converting VBG-operated patients to GBP results in a near-normalisation of acid reflux parameters and a discontinuation of proton pump inhibitor medication.
Authors:
M Ekelund; S Oberg; R Peterli; S G Frederiksen; J L Hedenbro
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obesity surgery     Volume:  22     ISSN:  1708-0428     ISO Abbreviation:  Obes Surg     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-10     Completed Date:  2012-08-20     Revised Date:  2012-10-04    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Clinical Sciences, Lund University, 221 85, Lund, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adult
Barium Sulfate / diagnostic use
Contrast Media / diagnostic use
Female
Gastric Bypass*
Gastroesophageal Reflux / etiology*,  radiography,  surgery*
Gastroplasty / adverse effects*
Humans
Middle Aged
Obesity, Morbid / complications,  radiography,  surgery*
Proton Pump Inhibitors
Treatment Failure
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Proton Pump Inhibitors; 7727-43-7/Barium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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