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Obesity Surgery
Published in: Obesity Surgery 6/2013

01-06-2013 | Original Contributions

Weight Loss and Weight Regain—5-Year Follow-Up for Circular- vs. Linear-Stapled Gastrojejunostomy in Laparoscopic Roux-en-Y Gastric Bypass

Authors: F. B. Langer, G. Prager, M. Poglitsch, R. Kefurt, S. Shakeri-Leidenmühler, B. Ludvik, K. Schindler, A. Bohdjalian

Published in: Obesity Surgery | Issue 6/2013

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Abstract

Background

Weight regain (WR) occurs in some patients after laparoscopic Roux-en-Y gastric bypass (LRYGBP). Loss of restriction due to dilation of the gastrojejunostomy (GJS) or the gastric pouch might be the main cause for WR. With different techniques available for the establishment of the GJS, the surgical technique might influence long-term success.

Methods

We present a 5-year follow-up for weight loss and WR of a matched-pair study comparing circular stapled (CSA) to linear stapled (LSA) GJS in a series of 150 patients who underwent primary antecolic antegastric LRYGBP. Complete 5-year follow-up was obtained for 79 % of the patients.

Results

Excess BMI loss (EBL) at 3 months was better with the CSA (p = 0.02) and comparable thereafter. The 5-year %EBL was 67.3 ± 23.2 vs. 73.3 ± 24.3 % (CSA vs. LSA, p = 0.19) WR of > 10 kg from nadir was found in 24 patients (16 %) with higher incidence in CSA than in LSA patients (20 % vs. 12 %). The %WR was comparable for both groups, 16 ± 13 vs. 15 ± 19 % (CSA vs. LSA, p = 0.345). Eleven patients underwent surgical re-intervention for WR by placement of a non-adjustable band (n = 2), adjustable band (n = 7) and conversion to distal gastric bypass (n = 2).

Conclusions

CSA and LSA lead to comparable weight loss in this 5-year follow-up. More patients in the CSA group had WR. Weight regain of more than 10 kg was found in one out of seven patients within 5 years postoperatively.
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Metadata
Title
Weight Loss and Weight Regain—5-Year Follow-Up for Circular- vs. Linear-Stapled Gastrojejunostomy in Laparoscopic Roux-en-Y Gastric Bypass
Authors
F. B. Langer
G. Prager
M. Poglitsch
R. Kefurt
S. Shakeri-Leidenmühler
B. Ludvik
K. Schindler
A. Bohdjalian
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 6/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-0892-4

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