目标:Roux-en-Y胃旁路术(RYGB)后,很少有患者出现严重并发症,这最终可能需要逆转RYGB。我们旨在研究RYGB逆转对症状和健康的影响。
方法:通过接触治疗RYGB患者的内科和外科部门,我们确定了18个病人,经历了逆转,2009-2019年。我们进行了一次丹麦,关于RYGB逆转前后症状的全国问卷调查,包括患者自己对其幸福感的看法。
结果:14名患者回答了问卷(86%为女性;RYGB的中位年龄,36.2年[IQR,30.9-38.6年])。从RYGB到逆转的中位时间为5.8年(IQR,5.1-7.5年)。在RYGB之后,13例患者(93%)报告腹痛,而12例患者逆转后仍有腹痛。11例患者中有6例(45%)报告逆转后倾倒/肥胖后低血糖(PBH)完全缓解。11例患者中有10例(90%)吸收不良消失。逆转对神经病变影响较小。RYGB的中位体重减轻为61公斤(IQR,56-75公斤),而逆转后的平均体重恢复为30公斤(IQR,13-46公斤)。关于幸福,72名患者在逆转后感觉更好或更好。
结论:总的来说,72%的患者在逆转RYGB后感觉更好或更好,尽管有些人仍然有与RYGB相关的症状。逆转缓解了倾销/PBH和吸收不良,但不是腹痛和神经病.最后,逆转后恢复了一半的体重减轻。在高度选择的情况下,逆转RYGB可能是一种选择。
OBJECTIVE: After Roux-en-Y gastric bypass (RYGB), few patients develop severe complications, which ultimately may require reversal of RYGB. We aimed to examine the effect of
reversal of RYGB on symptoms and well-being.
METHODS: Via contact to medical and surgical departments treating patients with RYGB, we identified 18 patients, who had undergone reversal, 2009-2019. We conducted a Danish, nationwide questionnaire survey concerning symptoms before and after reversal of the RYGB including the patients\' own perceptions of their well-being.
RESULTS: Fourteen patients responded to the questionnaire (86% female; median age at RYGB, 36.2 years [IQR, 30.9-38.6 years]). The median time from RYGB to
reversal was 5.8 years (IQR, 5.1-7.5 years). After RYGB, 13 patients (93%) reported abdominal pain, while 12 patients still had abdominal pain after reversal. Six out of 11 patients (45%) reported complete remission of dumping/post-bariatric hypoglycemia (PBH) after reversal. Malabsorption disappeared in 10 out of 11 patients (90%).
Reversal had minor effect on neuropathy. The median weight loss from RYGB was 61 kg (IQR, 56-75 kg), while the median weight regain after reversal was 30 kg (IQR, 13-46 kg). Regarding the well-being, 72 of the patients felt better or much better after reversal.
CONCLUSIONS: In total, 72% of the patients felt better or much better after reversal of RYGB, though some still had RYGB-related symptoms. The reversal relieved dumping/PBH and malabsorption, but not abdominal pain and neuropathy. Finally, half of the weight loss was regained after
reversal.
Reversal of RYGB may be an option in highly selected cases.