Carbajo CMA, García-Caballero M, Ortiz SJ, Osorio D, García-Lanza C

Language: Spanish
References: 19
Page: 5-10
PDF size: 58.55 Kb.

ABSTRACT

Objectives: Gastric bypass from a single anastomosis (GBSA) consist of the construction of a long and narrow gastric reservoir of approximately 20-25 cc from the gastric-esophageal connection to the end of the minor gastric curvature at the level of the so-called “goose’s foot”. Such a reservoir is anostomased in a lateral position to a jejunum handle excluded from the feeding tract at about a distance of 200-250 cm from Treitz’s angle. Our first 300 cases are analyzed and exposed here.
Materials and methods: Three-hundred patients were operated between July 2002 and May 2005. They were subjected to a modification of the conventional gastric bypass in the Y of Roux into a gastric bypass from a single anastomosis. The average age was of 40 years old (ranging from 14 to 72 years old); the average BMI was of 46 (ranging from 36 to 86) and the average excess of overweight was of 62 (ranging from 35 to 220). In 86 patients, the GBSA was accompanied by another simultaneous surgeries (32 cholecystectomies, 10 eventroplasties, one appendectomy, one giant parietal tumor, 2 hepatic hemangiomas, and 56 complex intra-abdominal adhesiolysis). In ten of the patients it was reconverted from another bariatric surgeries previous to the GBSA.
Results: In two cases (0.6%) there was the need of reconverting to minimal laparotomy due to an uncontrollable hemorrhage (one of them inside the gastric reservoir). Four patients (1.3%) needed to be to be re-operated in the immediate post-operative period. In six cases (2%) it was necessary to stay in hospital during a longer time due to an acute pancreatitis in a female patient, and anastomosic leakage or due to gastric transection in the rest of the patients. Two super-morbid patients died (0.6%); in one case due to a fulminating thromboembolism and in the other case due to uncontrollable nosocomial pneumonia. Just a few complications in the long term were found in two patients (0.6%) who developed a severe ferropenic anemia and needed an endovenous injection of Fe++. The average of the loss of weight was of 75% during the first year and over than 80% in those patients who have exceeded two years.
Conclusion: GBSA (Gastric Bypass from a Simple Anastomosis) is a relatively simple, easy, quick, secure, and very simple procedure in order to control and treat cases of Morbid Obesity. It presents less risk and perioperative complications and at distance than the conventional gastric bypass. Patient can count on a quick return to their routine activities, without having to follow diet restrictions and enjoying an optimum life quality.

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