Reliability and usefulness of upper gastro intestinal contrast studies to assess pouch size in patients with weight loss failure after Roux-en-Y gastric bypass

Martine Uittenbogaart*, Wouter K G Leclercq, Paul Smeele, A N van der Linden, Arijan A P M Luijten, Francois M H van Dielen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

Background: Weight loss failure or weight regain occurs in up to 25% of patients with a Roux-en-Y gastric bypass (RYGB). Post-operative anatomical changes, like pouch or stoma dilatation, might contribute. Aim of this study is to assess reliability and usefulness of upper gastro intestinal (UGI) contrast studies to detect pouch dilatation. Methods: Retrospective case-control study of patients with weight loss failure between 2010 and 2015 (failure group, n = 101) and a control group (n = 101) with adequate weight loss. Pouch dilatation was systematically reassessed. Clinical parameters were extracted from the electronic patient records. Results: Systematic reassessment showed 23/101 (23%) pouch dilatation in the failure group, compared to 11/101 (11%) in the control group (p = .024). Revision surgery was performed in 43/101 patients in the failure group. After this surgery, only 8% of patients with pouch dilatation achieved adequate weight loss, whereas 39% of patients without pouch dilatation achieved adequate weight loss (p = .07). There was no difference in return to adequate weight loss between patients treated surgically and conservatively (30% vs 28%). Conclusion: Systematic reassessment of UGI contrast studies showed 23% pouch dilatation in patients with weight loss failure after RYGB. However, low interobserver agreement and discrepancy in success rate of revision surgery greatly questions the reliability and usefulness of this diagnostic modality.

Original languageEnglish
Pages (from-to)329-333
Number of pages5
JournalActa Chirurgica Belgica
Volume120
Issue number5
Early online date27 Jun 2019
DOIs
Publication statusPublished - 2 Sep 2020

Keywords

  • Pouch dilatation
  • weight loss failure
  • weight regain
  • Roux-en-Y gastric bypass
  • measurement
  • COMPUTED-TOMOGRAPHY
  • BARIATRIC SURGERY
  • COMPLICATION
  • RECIDIVISM
  • VOLUMETRY
  • OUTCOMES

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