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2001, Number 3

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Rev Mex Cir Endoscop 2001; 2 (3)

Laparoscopic gastrojejunal bypass for morbid obesity: Initial experience

Fajardo-Cevallos R, Lajous LM, Gamino TSR, López AJC, González BJ, Herrera MF

Language: Spanish
References: 34
Page: 127-133
PDF size: 129.72 Kb.


ABSTRACT

Introduction: The gastrojejunostomy in Roux Y (GJ) it is one of the most frequently used interventions for the treatment of morbid obesity. At the present time it is possible to achieve it by laparoscopic via, wihich offers these patients the benefits of minimum invasive surgery. Objective: The purpose of this study is analyze our initial experience with the laparoscopic gastrojejunostomy. Material and methods: The first 50 patients treated in the last 15 months by this method were included, their demographic features, characteristics of the intervention, outcome and complications were evaluated. Results: The average age was 36 years (r: 21-57), 31 women and 19 men. The body mass index (BMI) average was 49 kg/m2 (r: 40-78), there were found, associated diseases like arterial hypertension in 41 patients, sleeping apnea in 38, diabetes mellitus in 23, hyperlipidemia in 18 and deep venous insufficiency disease of lower limbs in 16. 13 patients were treated with a circular stapler No. 25 for the gastrojejunostomy and 37 by manual suture in two planes. The average surgical time was of 4 h (r: 3-6). Postoperative complications were 4 surgical wound infections, 3 stenotic gastrojejunal anastomosis, 3 cases of rhabdomyolysis and 1 hematoma in the trocar insertion site, a patient died 2 weeks after the procedure because of respiratory insufficiency secondary to pneumonia. All the patients were studied with a gastro-esofagogram using hydro-soluble material at the first 24 after surgical intervention looking for anastomotic leakage and it was possible to initiate the enteral nutrition at the second day from surgery in all patients. Hospital stay average was 5 days. Weight loss was about 62% by the first year. Conclusion: The laparoscopic GJ is a secure and feasible technique. The surgical time is still prolonged secondary to the learning curve. The initial ponderal loss is satisfactory.


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