The Efficacy of Laparoscopic Roux-En-Y Gastric Bypass after Previous AntiReflux Surgery: A Single Surgeon Experience

Abstract

Background: In this study we assessed feasibility, weight loss results and recurrence of Gastro-Oesophageal Reflux Disease (GORD) in patients undergoing laparoscopic Roux-en-Y Gastric Bypass (RYGB) after previous antireflux surgery.Methods: Retrospective analysis of prospectively collected data was performed for patients undergoing laparoscopic RYGB after previous anti-refux surgery between 1/1/2000 and 1/1/2015. Weight loss was assessed using %Excess Weight Loss (%EWL) and every patient was compared with two matched control subjects. Telephone interviews were conducted to assure maximum follow-up data. Quality Of Life (QOL) was assessed using the Gastro-Intestinal Quality of Life Index (GIQLI), Gastro-intestinal Symptom Rating Scale (GSRS) and Bariatric Analysis and Reporting Outcome System (BAROS).Results: A total of 18 patients (11 female, 7 male) were identified (17 Nissen and 1 former Belsey-Mark IV fundoplica-tion). Mean time between surgical interventions was 9.4 years. Laparoscopic RYGB was feasible without intra-operative complications. One patient needed relaparoscopy for falsely suspected leakage and another suffered from postoperative pneumonia. Symptomatic GORD after RYGB was reported by 3 patients (16.7%). QOL was rated good with a GIQLI-score of 118 (range 97–140), GSRS score of 33 (range 15–59) and BAROS-score of 4, 6 (range 1.2–6.8). EWL 3 years after surgery was comparable with matched control subjects (80,1% vs. 79.2% in controls, P = 0,70). Conclusions: Laparoscopic conversion of anti-reflux surgery to RYGB is feasible and safe. Weight loss results are equal to control subjects and treatment of GORD is good. No significant decrease in QOL was reported.