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Published in: Journal of Gastrointestinal Surgery 1/2011

01-01-2011 | Original Article

Laparoscopic Resectional Gastric Bypass in Patients with Morbid Obesity: Experience on 112 Consecutive Patients

Authors: Italo Braghetto, Attila Csendes, Owen Korn, Luis Gutierrez, Luis Brunet, Enrique Lanzarini, Maher Mushle, Héctor Valladares, Jorge Rojas

Published in: Journal of Gastrointestinal Surgery | Issue 1/2011

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Abstract

Introduction

Gastric bypass, without gastric resection of the distal excluded stomach, is the surgical treatment more frequently performed for morbid obesity. Several postoperative complications related to the “in situ” distal stomach have been described, and few cases of undetected gastric carcinoma located in this segment of stomach have been published. In this paper, we present our early postoperative results in patients submitted to laparoscopic gastric bypass with resection of distal stomach in patients with morbid obesity.

Methods

One hundred twelve consecutive patients were included in this study. The mean body weight was 112.15 ± 5.1 (range 78–145), and BMI was 40.5 ± 6.9 kg/m2 (32.9–50.3). Patients were submitted to resectional gastric bypass by laparoscopic approach. The operative time was 133.7 ± 29.1 min (range 120–240).

Results

Postoperative complications occurred in 12 patients (10.7%) without any mortality. Early complications were observed in 11 patients while one patient presented a late complication, four patients were re-hospitalized, three of them without operation and other four of them were re-operated due to early (three patients) or late complication (one patient). One hundred patients (89.2%) were discharged at fourth postoperative day, seven patients remained in hospital between 5 and 10 days, and four patients after the tenth day due to complications. Leaks were observed in three patients. The histological study of the resected specimen was normal in only 8.9%.

Conclusions

Laparoscopic resectional gastric bypass presents very similar results compared to classic gastric bypass, without significant increase of morbidity, mortality, early and late postoperative results, and therefore, it is an option for the surgical treatment of morbid obesity in countries with high risk of gastric carcinoma.
Literature
1.
go back to reference Nguyen NT., Goldman C., Rosenquist CJ., Arango A, Cole CJ, Lee SJ, Wolfe BM. Laparoscopic versus open gastric by pass: a randomized study of outcomes quality of life and cost. Ann. Surg. 2001: 234: 279–291PubMedCrossRef Nguyen NT., Goldman C., Rosenquist CJ., Arango A, Cole CJ, Lee SJ, Wolfe BM. Laparoscopic versus open gastric by pass: a randomized study of outcomes quality of life and cost. Ann. Surg. 2001: 234: 279–291PubMedCrossRef
2.
go back to reference Schauer PHR., Ikaramudin S., Gourasch W., Outcomes after laparoscopic Roux-en-Y for morbid obesity. Ann. Surg. 2000; 10:233–39 Schauer PHR., Ikaramudin S., Gourasch W., Outcomes after laparoscopic Roux-en-Y for morbid obesity. Ann. Surg. 2000; 10:233–39
3.
go back to reference De Maria EJ., Sugerman HJ., Kellum JM., et las. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann. Surg. 2002: 235:640–5, discussion 5–7CrossRef De Maria EJ., Sugerman HJ., Kellum JM., et las. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann. Surg. 2002: 235:640–5, discussion 5–7CrossRef
4.
go back to reference Podnos Y., Jimenez JC., Wilson SE., Stevens CM., Nguyen NT. Complications after laparoscopic gastric bypass. Arch. Surg. 2003: 138:957–61PubMedCrossRef Podnos Y., Jimenez JC., Wilson SE., Stevens CM., Nguyen NT. Complications after laparoscopic gastric bypass. Arch. Surg. 2003: 138:957–61PubMedCrossRef
5.
go back to reference Csendes A., Burdiles P., Papapietro K., Diaz JC., Maluenda F., Burgos AM., Rojas J. Results of gastric Bypass plus resection of the distal excluded gastric segment in patients with morbid obesity. J. Gastrointest. Surg. 2005:9.121–31PubMedCrossRef Csendes A., Burdiles P., Papapietro K., Diaz JC., Maluenda F., Burgos AM., Rojas J. Results of gastric Bypass plus resection of the distal excluded gastric segment in patients with morbid obesity. J. Gastrointest. Surg. 2005:9.121–31PubMedCrossRef
6.
go back to reference Schauer PhR. Open and laparoscopic surgical modalities for the management of obesity. J. Gastrointest. Surg. 2003; 7: 468–75PubMedCrossRef Schauer PhR. Open and laparoscopic surgical modalities for the management of obesity. J. Gastrointest. Surg. 2003; 7: 468–75PubMedCrossRef
7.
go back to reference Bohdjalian A., Langer FB., Kranner A., Shakeri-Leidenmhler S., Zacher LJ., Prager G. Circular vs Linear stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obes. Surg 2010:20:440–446PubMedCrossRef Bohdjalian A., Langer FB., Kranner A., Shakeri-Leidenmhler S., Zacher LJ., Prager G. Circular vs Linear stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obes. Surg 2010:20:440–446PubMedCrossRef
8.
go back to reference De Roover A., Detry O., Desaive C., Maweja S., Coimbra C., Honoré P., Meurisse M. Risk of upper gastrointestinal cancer after bariatric operations. Obes. Surg 2006:16:1656–61PubMedCrossRef De Roover A., Detry O., Desaive C., Maweja S., Coimbra C., Honoré P., Meurisse M. Risk of upper gastrointestinal cancer after bariatric operations. Obes. Surg 2006:16:1656–61PubMedCrossRef
9.
go back to reference Corsini DA., Simonetti CAM., Moreira G. Cancer in the excluded stomach 4 years after gastric bypass. Obes. Surg 2006:16-932–4PubMedCrossRef Corsini DA., Simonetti CAM., Moreira G. Cancer in the excluded stomach 4 years after gastric bypass. Obes. Surg 2006:16-932–4PubMedCrossRef
10.
go back to reference Escalona A., Guzman S., Ibañez L., Meneses L., Huete A., Solar A. Gastric cancer after Roux-en-Y gastric bypass. Obes Surg 2005:17:423–27CrossRef Escalona A., Guzman S., Ibañez L., Meneses L., Huete A., Solar A. Gastric cancer after Roux-en-Y gastric bypass. Obes Surg 2005:17:423–27CrossRef
11.
go back to reference Heise K., Bertran E., Andia ME., Ferreccio C. Incidence and survival of stomach cancer in a high risk population of Chile. World J. Gastroenterol. 2009:15:1854–62PubMedCrossRef Heise K., Bertran E., Andia ME., Ferreccio C. Incidence and survival of stomach cancer in a high risk population of Chile. World J. Gastroenterol. 2009:15:1854–62PubMedCrossRef
12.
go back to reference Bertuccio P., Chatenoud L., Levi F., Praud D., Feraly J., Negri E., Malvezzi M., La Vecchia C. Recent pattern in gastric cancer: a global overview. Intl J. Cancer 2009:125:666–73CrossRef Bertuccio P., Chatenoud L., Levi F., Praud D., Feraly J., Negri E., Malvezzi M., La Vecchia C. Recent pattern in gastric cancer: a global overview. Intl J. Cancer 2009:125:666–73CrossRef
13.
go back to reference Calderon ME., Csendes A., Ospina C., Lara A., Hodgson F. Evolucion del cáncer gástrico en 30 años. 1975–2005. Rev Chil. Cir. 2007:59:366–69 Calderon ME., Csendes A., Ospina C., Lara A., Hodgson F. Evolucion del cáncer gástrico en 30 años. 1975–2005. Rev Chil. Cir. 2007:59:366–69
14.
go back to reference Ettinger JE., Ramos AC., Azaro E, Galvão-Neto MP., Mello CA., Galvão MS., Amaral PC. Staplerless laparoscopic gastric bypass: a new option in bariatric surgery. Obes Surg. 2006:16:638–45PubMedCrossRef Ettinger JE., Ramos AC., Azaro E, Galvão-Neto MP., Mello CA., Galvão MS., Amaral PC. Staplerless laparoscopic gastric bypass: a new option in bariatric surgery. Obes Surg. 2006:16:638–45PubMedCrossRef
15.
go back to reference Kasama K.,Tagaya N., Kanehira E., Oshiro T., Seki Y., Kinouchi M., Umezawa A., Negishi Y, Kurokawa Y. Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass: Technique and Preliminary Results. Obes Surg. 2009:19:1341–5PubMedCrossRef Kasama K.,Tagaya N., Kanehira E., Oshiro T., Seki Y., Kinouchi M., Umezawa A., Negishi Y, Kurokawa Y. Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass: Technique and Preliminary Results. Obes Surg. 2009:19:1341–5PubMedCrossRef
16.
go back to reference Savik TT., Taha O., Aasheim ET., Engstram M., Kristinsson J., Bjarkman S., Schou CF., Lanroth H., Mala T., Olbers T. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Br J Surg. 2010:97:160–6CrossRef Savik TT., Taha O., Aasheim ET., Engstram M., Kristinsson J., Bjarkman S., Schou CF., Lanroth H., Mala T., Olbers T. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Br J Surg. 2010:97:1606CrossRef
17.
go back to reference Weber M., Maller MK., Bucher T., Wildi S., Dindo D., Horber F., Hauser R., Clavien PA. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004:240:975–82; discussion 982–3.PubMedCrossRef Weber M., Maller MK., Bucher T., Wildi S., Dindo D., Horber F., Hauser R., Clavien PA. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004:240:975–82; discussion 982–3.PubMedCrossRef
18.
go back to reference Nyugen NT., Slone JA., Nyugen XM., Hartman JS., Hoyt DB. A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic Adjustable Gastric Banding for the treatment of morbid obesity: outcomes, quality of life and costs. Ann. Surg. 2009: 250:631–641 Nyugen NT., Slone JA., Nyugen XM., Hartman JS., Hoyt DB. A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic Adjustable Gastric Banding for the treatment of morbid obesity: outcomes, quality of life and costs. Ann. Surg. 2009: 250:631–641
19.
go back to reference Schauer PhR., Ikramuddin S. Laparoscopic surgery for morbid obesity. Surg Clin N.A. 2001:81: 1145–79CrossRef Schauer PhR., Ikramuddin S. Laparoscopic surgery for morbid obesity. Surg Clin N.A. 2001:81: 1145–79CrossRef
20.
go back to reference Puzziferri N., Austrheim-Smith IT., Wolfe BM., Wilson SE., Nguyen NT. Three-year follow-up of a prospective randomized trial comparing laparoscopic versus open gastric bypass. Ann Surg. 2006:243:181–8PubMedCrossRef Puzziferri N., Austrheim-Smith IT., Wolfe BM., Wilson SE., Nguyen NT. Three-year follow-up of a prospective randomized trial comparing laparoscopic versus open gastric bypass. Ann Surg. 2006:243:181–8PubMedCrossRef
21.
go back to reference Ruiz de Adana JC., Hernández Matas A., Hernández Bartolomeo M., Manzanedo Romero I, Leon Ledesma R., Valle Rubio A., López Herrero J., Limones Esteban M. Risk of gastrojejunal anastomotic stricture with multifilament and monofilament sutures after hand-sewn laparoscopic gastric bypass: a prospective cohort study. Obes Surg. 2009:19:1274–7PubMedCrossRef Ruiz de Adana JC., Hernández Matas A., Hernández Bartolomeo M., Manzanedo Romero I, Leon Ledesma R., Valle Rubio A., López Herrero J., Limones Esteban M. Risk of gastrojejunal anastomotic stricture with multifilament and monofilament sutures after hand-sewn laparoscopic gastric bypass: a prospective cohort study. Obes Surg. 2009:19:12747PubMedCrossRef
22.
go back to reference Bell BJ, Bour ES., Scott JD., Cobb WS., Carbonell AM. Management of complications after laparoscopic Roux-en-Y gastric bypass. Minerva Chir. 2009:64:265–76PubMed Bell BJ, Bour ES., Scott JD., Cobb WS., Carbonell AM. Management of complications after laparoscopic Roux-en-Y gastric bypass. Minerva Chir. 2009:64:265–76PubMed
23.
go back to reference Szomstein S., Kaidar-Person O., Naberezny K., Cruz-Correa M., Rosenthal R. Correlation of radiographic and endoscopic evaluation of gastrojejunal anastomosis after Roux-en-Y gastric bypass. Surg. Obes. Relat. Dis. 2006:2:617–21PubMedCrossRef Szomstein S., Kaidar-Person O., Naberezny K., Cruz-Correa M., Rosenthal R. Correlation of radiographic and endoscopic evaluation of gastrojejunal anastomosis after Roux-en-Y gastric bypass. Surg. Obes. Relat. Dis. 2006:2:617–21PubMedCrossRef
24.
go back to reference Csendes. A., Burgos AM., Burdiles P. Incidence of anastomotic strictures after gastric bypass: a prospective consecutive routine endoscopic study 1 month and 17 months after surgery in 441 patients with morbid obesity. Obes. Surg. 2009:19:269–73PubMedCrossRef Csendes. A., Burgos AM., Burdiles P. Incidence of anastomotic strictures after gastric bypass: a prospective consecutive routine endoscopic study 1 month and 17 months after surgery in 441 patients with morbid obesity. Obes. Surg. 2009:19:269–73PubMedCrossRef
25.
go back to reference Maclean LD., Rhode BM., Nohr CW. Late outcome of isolated gastric bypass. Ann Surg 2000:231:524–28PubMedCrossRef Maclean LD., Rhode BM., Nohr CW. Late outcome of isolated gastric bypass. Ann Surg 2000:231:524–28PubMedCrossRef
26.
go back to reference Nguyen NT., Wilson SE. Complications of antiobesity surgery. Nat. Clin. Pract Gastroenterol &hepatol. 2007:4:138–147CrossRef Nguyen NT., Wilson SE. Complications of antiobesity surgery. Nat. Clin. Pract Gastroenterol &hepatol. 2007:4:138–147CrossRef
27.
go back to reference Silecchia GF., Boru CE., Rossi M., Anselmino M., Morino M., Toppino M., Gaspari A., Gentileschi P., Tacchino R., Basso N. The use of fibrin sealant to prevent major complications following laparoscopic gastric bypass: results of a multicenter, randomized trial. Surg. Endosc. 2008: 22:2492–97PubMedCrossRef Silecchia GF., Boru CE., Rossi M., Anselmino M., Morino M., Toppino M., Gaspari A., Gentileschi P., Tacchino R., Basso N. The use of fibrin sealant to prevent major complications following laparoscopic gastric bypass: results of a multicenter, randomized trial. Surg. Endosc. 2008: 22:2492–97PubMedCrossRef
28.
go back to reference Csendes A., Burdiles P., Burgos AM., Maluenda F., Diaz JC. Conservative management of anastomotic leaks after 557 open gastric bypasses. Obes Surg. 2005:15:1252–6PubMedCrossRef Csendes A., Burdiles P., Burgos AM., Maluenda F., Diaz JC. Conservative management of anastomotic leaks after 557 open gastric bypasses. Obes Surg. 2005:15:1252–6PubMedCrossRef
29.
go back to reference Mozzi E., Lattuada E., Zappa MA., Antonini I., Andreoli F., Badiali S., Roviaro G. Failure of gastric bypass following several gastrointestinal hemorrhages. Obes. Surg 2010:20: 523–25PubMedCrossRef Mozzi E., Lattuada E., Zappa MA., Antonini I., Andreoli F., Badiali S., Roviaro G. Failure of gastric bypass following several gastrointestinal hemorrhages. Obes. Surg 2010:20: 523–25PubMedCrossRef
30.
go back to reference Nguyen NT., Longoria M., Chalifox., S., Wilson SE. Gastrointestinal hemorrhage after laparoscopic gastric bypass. Obes. Surg 2004:14:1308–12PubMedCrossRef Nguyen NT., Longoria M., Chalifox., S., Wilson SE. Gastrointestinal hemorrhage after laparoscopic gastric bypass. Obes. Surg 2004:14:1308–12PubMedCrossRef
31.
go back to reference Champion JK., Hunt T., DeLisle N. Laparoscopic banded gastroplasty and Roux-en-Y gastric bypass in morbid obesity. Obes Surg 1999:9:123CrossRef Champion JK., Hunt T., DeLisle N. Laparoscopic banded gastroplasty and Roux-en-Y gastric bypass in morbid obesity. Obes Surg 1999:9:123CrossRef
32.
go back to reference Cucchi SG., Pories WJ., Morgan EJ. Gastro-gastro fistulas: a complication of divided gastric bypass surgery. Ann. Surg. 1995:221:387–91PubMedCrossRef Cucchi SG., Pories WJ., Morgan EJ. Gastro-gastro fistulas: a complication of divided gastric bypass surgery. Ann. Surg. 1995:221:387–91PubMedCrossRef
33.
go back to reference Csendes. A., Burgos AM., Altuve J., Bonacic S. Incidence of marginal ulcer 1 month and 1–2 years after gastric bypass: a prospective consecutive endoscopic evaluation of 442 patients with morbid obesity. Obes. Surg. 2009:19:135–38PubMedCrossRef Csendes. A., Burgos AM., Altuve J., Bonacic S. Incidence of marginal ulcer 1 month and 1–2 years after gastric bypass: a prospective consecutive endoscopic evaluation of 442 patients with morbid obesity. Obes. Surg. 2009:19:135–38PubMedCrossRef
34.
go back to reference Defoort B., Dillemans B:, Mulier J., Cabooter M. Marginal Ulcer after Roux-en Y gastric Bypass. Obes. Surg. 2008: 18: 432–185 (Abst 11)CrossRef Defoort B., Dillemans B:, Mulier J., Cabooter M. Marginal Ulcer after Roux-en Y gastric Bypass. Obes. Surg. 2008: 18: 432–185 (Abst 11)CrossRef
35.
go back to reference Braley SC., Nguyen NT., Wolfe BM. Late gastrointestinal hemorrhage after gastric bypass. Obes. Surg. 2002:12:404–7PubMedCrossRef Braley SC., Nguyen NT., Wolfe BM. Late gastrointestinal hemorrhage after gastric bypass. Obes. Surg. 2002:12:404–7PubMedCrossRef
36.
go back to reference Dillemans B., Defoort B., Mulier J. Laparoscopic management of a gastro-gastric fistula after laparoscopic Roux-en-Y gastric bypass. Obes. Surg 2008:18: 432–485. (Abst112)CrossRef Dillemans B., Defoort B., Mulier J. Laparoscopic management of a gastro-gastric fistula after laparoscopic Roux-en-Y gastric bypass. Obes. Surg 2008:18: 432–485. (Abst112)CrossRef
37.
go back to reference Kellum JM, DeMaria EJ, Sugerman HJ. The surgical treatment of morbid obesity. Curr Probl Surg. 1998:35:791–858PubMedCrossRef Kellum JM, DeMaria EJ, Sugerman HJ. The surgical treatment of morbid obesity. Curr Probl Surg. 1998:35:791–858PubMedCrossRef
38.
go back to reference Flum DR., Salem L., Elrod JA., Dellinger EP., Cheadle A., Chan L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA 2005:294:1903–8PubMedCrossRef Flum DR., Salem L., Elrod JA., Dellinger EP., Cheadle A., Chan L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA 2005:294:1903–8PubMedCrossRef
39.
go back to reference Nguyen NT. Silver M, Robinson M, Needleman B, Hartley G, Cooney R, Catalano R, Dostal J, Sama D, Blankenship J, Burg K, Stemmer E, Wilson SE. Results of a national audit of bariatric surgery performed at academic centers: a 2004 University Healthsystem Consortium benchmarking project. Arch Surg. 2006: 141:445–9; discussion 449–50PubMedCrossRef Nguyen NT. Silver M, Robinson M, Needleman B, Hartley G, Cooney R, Catalano R, Dostal J, Sama D, Blankenship J, Burg K, Stemmer E, Wilson SE. Results of a national audit of bariatric surgery performed at academic centers: a 2004 University Healthsystem Consortium benchmarking project. Arch Surg. 2006: 141:445–9; discussion 449–50PubMedCrossRef
40.
go back to reference Kuga R, Safatle-Ribeiro AV, Faintuch J, Ishida RK, Furuya CK Jr, Garrido AB Jr, Cecconello I, Ishioka S, Sakai P. Endoscopic findings in the excluded stomach after Roux-en-Y gastric bypass surgery. Arch Surg. 2007:142:942–6PubMedCrossRef Kuga R, Safatle-Ribeiro AV, Faintuch J, Ishida RK, Furuya CK Jr, Garrido AB Jr, Cecconello I, Ishioka S, Sakai P. Endoscopic findings in the excluded stomach after Roux-en-Y gastric bypass surgery. Arch Surg. 2007:142:942–6PubMedCrossRef
41.
go back to reference Raijman I., Strother V., Donegan W. Gastric cancer after gastric bypass for obesity. J. Clin. Gastroenterol. 1991:13:191–4PubMedCrossRef Raijman I., Strother V., Donegan W. Gastric cancer after gastric bypass for obesity. J. Clin. Gastroenterol. 1991:13:191–4PubMedCrossRef
42.
go back to reference Lord RV., Edwards P., Coleman M. Gastric cancer in the bypassed segment after operation for morbid obesity. Aust N.Z. J. Surg. 1997;67:580PubMedCrossRef Lord RV., Edwards P., Coleman M. Gastric cancer in the bypassed segment after operation for morbid obesity. Aust N.Z. J. Surg. 1997;67:580PubMedCrossRef
43.
go back to reference Inoue H., Rubino F., Shimada y., Lindner V., Inoue M., Riegel Ph., Marescaux J. Risk of gastric cancer after Roux-en-Y gastric bypass. Arch Surg. 2007:142:947–53PubMedCrossRef Inoue H., Rubino F., Shimada y., Lindner V., Inoue M., Riegel Ph., Marescaux J. Risk of gastric cancer after Roux-en-Y gastric bypass. Arch Surg. 2007:142:947–53PubMedCrossRef
44.
go back to reference De Roover A., Detry O., de Leval L., Coimbra C., Desaive C., Honore P., Meurise M. Report of two cases of gastric cáncer after baraitric suegery: lymphoma of the bypassed stomach after Roux-en-Y gastric bypass and gastrointestinal stromal tumor (GIST) after vertical banded gastroplasty. Obes, surg 2006:16:928–931PubMedCrossRef De Roover A., Detry O., de Leval L., Coimbra C., Desaive C., Honore P., Meurise M. Report of two cases of gastric cáncer after baraitric suegery: lymphoma of the bypassed stomach after Roux-en-Y gastric bypass and gastrointestinal stromal tumor (GIST) after vertical banded gastroplasty. Obes, surg 2006:16:928–931PubMedCrossRef
45.
go back to reference Khitin L., Roses RE., Birkett Dh. Cancer in the gastric remnant after gastric bypass.: a case report. Curr Surg. 2003:60:521–23PubMedCrossRef Khitin L., Roses RE., Birkett Dh. Cancer in the gastric remnant after gastric bypass.: a case report. Curr Surg. 2003:60:521–23PubMedCrossRef
46.
go back to reference Babor R., Booth M., Adenocarcinoma of the gastric pouch 26 years after loop gastric bypass. Obes. Surg 2006:16:935–8PubMedCrossRef Babor R., Booth M., Adenocarcinoma of the gastric pouch 26 years after loop gastric bypass. Obes. Surg 2006:16:935–8PubMedCrossRef
47.
go back to reference Flickinger EG, Sinar DR., Pories WJ., Sloss RR, Park HK, Gibson JH. The bypassed stomach. Am. J. Surg 1985:149:151–6PubMedCrossRef Flickinger EG, Sinar DR., Pories WJ., Sloss RR, Park HK, Gibson JH. The bypassed stomach. Am. J. Surg 1985:149:151–6PubMedCrossRef
48.
go back to reference Saflate-Ribeiro AV., Ribeiro U Jr., Reynolds JC. Gastric stump cáncer: what is the risk? Dig Dis. 1998:16:159–68CrossRef Saflate-Ribeiro AV., Ribeiro U Jr., Reynolds JC. Gastric stump cáncer: what is the risk? Dig Dis. 1998:16:159–68CrossRef
49.
go back to reference Sundbom M., Hedenström H., Gustavsson S. Duodenogastric bile reflux after gastric bypass: A cholescintigraphic study. Dig Dis Sciences 2002:47:1891–1896CrossRef Sundbom M., Hedenström H., Gustavsson S. Duodenogastric bile reflux after gastric bypass: A cholescintigraphic study. Dig Dis Sciences 2002:47:1891–1896CrossRef
50.
go back to reference Chao Zh., Zhan Kui Liu Pei-Wu Yu. Effects of bile reflux and intragastric microflora changes on lesions of remnant gastric mucosa after gastric operation. World J. Gastroent 2004:10:1537–39 Chao Zh., Zhan Kui Liu Pei-Wu Yu. Effects of bile reflux and intragastric microflora changes on lesions of remnant gastric mucosa after gastric operation. World J. Gastroent 2004:10:1537–39
51.
go back to reference Bestman R., Valk J., De Clerk S., Hendrickh L. Laparoscopic reversal of gastric Bypass. Obes. Surg 2008:18: 432–485. (Abst115)CrossRef Bestman R., Valk J., De Clerk S., Hendrickh L. Laparoscopic reversal of gastric Bypass. Obes. Surg 2008:18: 432–485. (Abst115)CrossRef
Metadata
Title
Laparoscopic Resectional Gastric Bypass in Patients with Morbid Obesity: Experience on 112 Consecutive Patients
Authors
Italo Braghetto
Attila Csendes
Owen Korn
Luis Gutierrez
Luis Brunet
Enrique Lanzarini
Maher Mushle
Héctor Valladares
Jorge Rojas
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 1/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-010-1383-8

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