Highlights
- •Gastrogastric fistula (GGF) repair induces long-term weight loss after weight recurrence.
- •Surgical repair can be safely performed, however with higher complication rates.
- •GGFs are more common after open undivided Roux-en-Y gastric bypass (RYGB).
Abstract
Background
Gastrogastric fistula (GGF) is a rare complication from Roux-en-Y gastric bypass (RYGB).
It is a known risk factor associated with weight recidivism and an indication for
Bariatric Revisional Surgery (BRS).
Objectives
The primary outcome of this study is to evaluate perioperative outcomes and the long-term
total body weight loss (TBWL) outcomes following revision.
Setting
Single Academic Institution, Center of Bariatric Excellence.
Methods
We selected patients who had primary bariatric surgery and BRS from 2003 to 2020,
followed by BRS for GGF. Patients’ demographics, perioperative outcomes, and TBWL
were analyzed.
Results
One hundred five patients underwent BRS for GGF. Mean body mass index (BMI) at index
operation and revision was 51.6 ± 10.1, and 42.4 ± 11.2 respectively. Ninety percent
of patients had open primary RYGB, and 69% had open revisional surgery. The median
length of stay after BRS was 3 days. The 30-day reintervention rate was 19%. The 30-day
readmission rate was 34%. Of the 77 patients included for weight loss analysis, the
mean %TBWL after primary RYGB was 34% ± 14. The total mean %TBWL at the time of revision
was 18.8%, translating into a weight regain of 13.6% ± 9.5. The total mean %TBWL after
revision was 37.6% ± 11.4, translating into TBWL of 18.8% ± 9.4 after revision when
compared to TBWL at revision time.
Conclusions
Our results demonstrate that revision for GGF can be safely performed, however is
associated with higher morbidity than primary bariatric surgery. Revision for GGF
results in significant long-term weight loss.
Keywords
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Article info
Publication history
Published online: December 10, 2022
Accepted:
December 1,
2022
Received:
September 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.
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- Comment on: BARIATRIC REVISIONAL SURGERY FOR GASTRO-GASTRIC FISTULA FOLLOWING ROUX-EN-Y GASTRIC BYPASS POSITIVELY IMPACTS WEIGHT LOSSSurgery for Obesity and Related Diseases
