Indications and outcomes of reversal of Roux-en-Y gastric bypass

Background: Laparoscopic Roux-en-Y gastric bypass (RYGB) is proven to be a safe and effective treatment of obesity and related co-morbidities. However, there is a small group of patients who are unable to tolerate postoperative complications and ultimately undergo reversal procedures. This study demonstrates indications and postoperative outcomes in 8 patients following RYGB reversal. Methods: Retrospective review of 8 patients who required RYGB reversal between July 2009 to October 2013. Data points included demographic characteristics, body mass index (BMI), comorbidities, reasons for reversal and postoperative outcomes. Results: All patients were female with a mean age of 44.5 +/- 8.8 years (range, 35-63) and BMI of 30.0 +/- 9.8 kg/m(2) (range, 19.3-438) before reversal. Reasons for reversal included recurrent anastomotic ulcer (n = 3), intractable nausea and emesis (n = 3), hypocalcemia (n = 1), and neuroglycopenia (n = 1). Mean period from RYGB to reversal was 127.8 +/- 95.4 months (range, 21-298) and mean length of hospital stay following reversal was 5.1 +/- 3.0 days (range, 2-11). One patient was lost to follow-up. Mean BMI at the last visit was 37.3 +/- 12.6 kg/m(2) (range, 24.0-56.5). Two patients (28.6%) maintained the same weight 9 and 11 months after reversal. One returned to her pre-RYGB weight and 4 patients gained some of their weight back after reversal. Three (37.5%) patients required readmissions for abdominal pain and nausea/vomiting, and no patients required reoperations following RYGB reversal. Conclusions: Reversal of RYGB to normal anatomy is reasonable in patients with severe or refractory complications. (C) 2015 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.