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Gastroesophageal Reflux after Vertical Banded Gastroplasty is Alleviated by Conversion to Gastric Bypass.

Ekelund, Mikael LU ; Öberg, Stefan LU ; Peterli, R; Frederiksen, S G and Hedenbro, Jan LU (2012) In Obesity Surgery 22(6). p.851-854
Abstract
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... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Obesity Surgery
volume
22
issue
6
pages
851 - 854
publisher
Springer
external identifiers
  • wos:000304117100002
  • pmid:22052197
  • scopus:84862623904
ISSN
1708-0428
DOI
10.1007/s11695-011-0540-9
language
English
LU publication?
yes
id
6d232c07-0940-45d7-9a61-ec958aa166c3 (old id 2221168)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22052197?dopt=Abstract
http://link.springer.com/article/10.1007%2Fs11695-011-0540-9
date added to LUP
2011-12-02 19:11:39
date last changed
2017-01-01 06:33:57
@article{6d232c07-0940-45d7-9a61-ec958aa166c3,
  abstract     = {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. <br/><br>
<br/><br>
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. <br/><br>
<br/><br>
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 &lt; 4.0 was reduced from 18.4% to 3.3% (p &lt; 0.05). DeMeester score was reduced from 58.1 to 15.9 (p &lt; 0.05). <br/><br>
<br/><br>
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.},
  author       = {Ekelund, Mikael and Öberg, Stefan and Peterli, R and Frederiksen, S G and Hedenbro, Jan},
  issn         = {1708-0428},
  language     = {eng},
  number       = {6},
  pages        = {851--854},
  publisher    = {Springer},
  series       = {Obesity Surgery},
  title        = {Gastroesophageal Reflux after Vertical Banded Gastroplasty is Alleviated by Conversion to Gastric Bypass.},
  url          = {http://dx.doi.org/10.1007/s11695-011-0540-9},
  volume       = {22},
  year         = {2012},
}