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Weight regain after gastric by-pass

Weight regain after gastric by-pass. Ass Pr Jean BIAGINI. Weight regain after gastric by-pass. At 10 yrs failure rate (BMI > 35) 20% for MO and 35% for SO, limb length doesn't impact long term weight loss . Ann Surg 2006, Christou et al.

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Weight regain after gastric by-pass

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  1. Weight regain after gastric by-pass Ass Pr Jean BIAGINI

  2. Weight regain after gastric by-pass • At 10 yrs failure rate (BMI > 35) 20% for MO and 35% for SO, limb length doesn't impact long term weight loss. Ann Surg 2006, Christou et al. • Weight regain (>8% WL) is 50% at 24 months mainly in super obese. Metabolic & hormonal mechanisms? Obes Surgery 2008 Magro et al. • Hyperphagia is the major cause of weight regain, Lap placement of of non adjustable Silicone Ring. Obes Surg 2009, dapri et al

  3. Weight regain after gastric by-passPersonnal experience • 16 cases, Barium UGI study role • 3 Adjustable gastric band, 1good result, 2 moderate • 1 case gastric pouch reduction, moderate result • 1 case alimentary limb lengthening, bad result • 2 cases Gastrectomy for gastro-gastric fistula • 1 case of jejunal limb diameter reduction • 8 cases non-adjustable silicone band

  4. Weight regain after gastric by-passPersonal experience, gastric dilation

  5. Weight regain after gastric by-passPersonal experience, gastro-gastric fistula

  6. Weight regain after gastric by-passPersonal experience, jejunal dilation

  7. Weight regain after gastric by-passPersonal experience, anastomotic & jejunaldiam reduction

  8. Weight regain after gastric by-passPersonal experience, normal UGI

  9. Weight regain after gastric by-passPersonal experience, Home made “Fobi ring”

  10. Weight regain after gastric by-passPersonal experience, ring on the anastomosis

  11. Weight regain after gastric by-passPersonal experience, Weight regain

  12. Weight regain after gastric by-passPersonal experience, after band

  13. Weight regain after gastric by-passNH, band failure

  14. Weight regain after gastric by-passNH, mini GBP

  15. Weight regain after gastric by-passNH, weight regain, jejunal dilation>> 7cm fixed band

  16. Weight regain after gastric by-passNon adjustable band experience • 8 cases with normal gastric pouch. • Band: 5.6cm-8cm, usually 7 or 7.5cm. • 36 fr calibrating tube. • 6 laparoscopic, 2 open. • Weight reduction: 6-25kgs.

  17. Weight regain after gastric by-passConclusions • Importance of Barium UGI study to detect and repair an anatomical cause (big pouch, wide anastomosis, gastro-gastric fistula etc) • If acceptable anatomy>> Non Adjustable silicone band. • Alternative: Stomafix, jejuno-anastomo-gastric pouch sleeve or plication.

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