Background: Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty (RYGB-on-VBG) is a modified Roux-en-Y Gastric Bypass (RYGB) where a small communication between the gastric pouch and the exluded stomach enables the traditional upper endoscopy of remnant. We present the results of endoscopic studies of remnant performed in patients who underwent that procedure, with follow-up over 5 year. Methods: From January 2009, 30 asymptomatic patients with good results in term of weight loss after RYGB-on-VBG, performed between 2002 and 2004, were enrolled for standard upper endoscopy. Before surgery, for all patients gastroscopy showed a normal mucosal pattern. Using standard biopsy forceps in oral sedation with Olimpus Video Gastroscope GIF-Q 165 (Ø 9,2 mm distal-end), biopsies of corpus, angulus and antrum of the functionally excluded stomach were collected. Results: The traditional upper endoscopy of remnant in 3 cases (10%) showed a normal mucosal pattern, while mild and severe gastritis were detected in 17 (57%) and 10 (33%) cases respectively. The results of hystological analysis were a normal pattern in 1 case (3,3%), intestinal metaplasia in 1 case (3.3%), lymphoma-like gastritis in 1 case (3,3%), cronic gastritis in 12 cases (40%) and active gastritis in 14 cases (46%). Conclusions: In spite of 30 asypmtomatic patients, the upper endoscopy after RYGB-on-VBG in the mid-term showed an hight incidence of pathological changes of gastric mucosa in the functional excluded stomach. These findings suggest the importance of a bariatric surgical technique wich allows the endoscopic study of gastric remnant in the follow-up of patients.

ENDOSCOPIC FINDINGS OF GASTRIC REMNANT OVER 5 YEARS AFTER ROUX-EN-Y GASTRIC BYPASS ON VERTICAL BANDED GASTROPLASTY

CARIANI, STEFANO;LEURATTI, LUCA;AGOSTINELLI, LAURA;GIORGINI, ELEONORA;DI SIMONE, MASSIMO PIERLUIGI
2010

Abstract

Background: Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty (RYGB-on-VBG) is a modified Roux-en-Y Gastric Bypass (RYGB) where a small communication between the gastric pouch and the exluded stomach enables the traditional upper endoscopy of remnant. We present the results of endoscopic studies of remnant performed in patients who underwent that procedure, with follow-up over 5 year. Methods: From January 2009, 30 asymptomatic patients with good results in term of weight loss after RYGB-on-VBG, performed between 2002 and 2004, were enrolled for standard upper endoscopy. Before surgery, for all patients gastroscopy showed a normal mucosal pattern. Using standard biopsy forceps in oral sedation with Olimpus Video Gastroscope GIF-Q 165 (Ø 9,2 mm distal-end), biopsies of corpus, angulus and antrum of the functionally excluded stomach were collected. Results: The traditional upper endoscopy of remnant in 3 cases (10%) showed a normal mucosal pattern, while mild and severe gastritis were detected in 17 (57%) and 10 (33%) cases respectively. The results of hystological analysis were a normal pattern in 1 case (3,3%), intestinal metaplasia in 1 case (3.3%), lymphoma-like gastritis in 1 case (3,3%), cronic gastritis in 12 cases (40%) and active gastritis in 14 cases (46%). Conclusions: In spite of 30 asypmtomatic patients, the upper endoscopy after RYGB-on-VBG in the mid-term showed an hight incidence of pathological changes of gastric mucosa in the functional excluded stomach. These findings suggest the importance of a bariatric surgical technique wich allows the endoscopic study of gastric remnant in the follow-up of patients.
Cariani S; Leuratti L; Agostinelli L; Giorgini E; Di Simone M P
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/123645
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