OUTCOME OF MINI GASTRIC BYPASS AFTER FAILED VERTICAL BAND GASTROPLASTY IN TREATMENT OF MORBID OBESE PATIENTS

Background: Bariatric surgery has long been introduced for weight control if conservative treatment failed and was widely accepted in the past decades. Compared with nonsurgical strategies, bariatric surgery proves more effectiveness for moderately to severely obese people to lose weight. Besides, bariatric surgery was demonstrated to induce significant and long-term remission of obesity related comorbidities.
Aim of The Work: The aim of this study to review the outcome of Mini gastric bypass as a line of management of failed VBG operation in treatment of morbid obese patients as regard weight loos, intraoperative complications, postoperative complications and other comorbidities within one year follow up after operation.
Patients and Methods: Our study includes thirty (30) morbidly obese patients who fulfilled the criteria for bariatric surgery with BMI >40 or >35 with associated co-morbidities with failure of previous restrictive operation (VBG). These patients were enrolled in a prospective study and had a retrospectively gathered outcome analysis at the department of surgery Ain-Shams University Hospitals. Our study was conducted in El-Demerdash hospital, Ain- Shams University. Thirty patients were selected and operated upon from June 2017 till June 2019 and followed up to June 2020.
Results: In our study causes of revision in (30) patients: weight regain (10) patients severe GERD (9) patients, un satisfactory weight loss (8) patients, eating difficulties (3) patients. In our study The mean initial BMI for the patients was The preoperative BMI with mean ± SD: 42.9 ± 7.21 kg/m2, was higher than post-operative BMI at 3 months with mean ± SD value of 38.03± 5.62 kg/m2), than post-operative BMI at 6 months with mean ± SD value of 33.98 ± 4.58 kg/m2, than post-operative BMI at 12 months with mean ± SD value of 29.22 ± 3.60 kg/m2.
Conclusion: Mini-gastric bypass offers major benefits with quite satisfactory results over most alternative procedures. Our data, which includes follow up of two years, indicates that mini gastric bypass is: An effective procedure for the treatment of failed restrictive procedure (VBG). Technically feasible. Safe operation with a low rate of major postoperative complications. Has a significant reduction in patient’s hospital stay. Helps in the achievement of a significant weight loss and improvement of obesity related metabolic co morbidities. Efficient in loosing excess weight and in maintaining the weight loss. so it is considered a promising revisional bariatric procedure operation for patients with failed prior open or laparoscopic VBG