Maaroof Payam, Tezekbay Aslanbi, Addi Palle Lokeshwar Raaju, Kim Jane, Kraft Jeffrey J
General Surgery, Hackensack Meridian Health - Palisades Medical Center, North Bergen, USA.
Surgery, Kamala Children's Hospital, Chennai, IND.
Cureus. 2023 Aug 4;15(8):e42967. doi: 10.7759/cureus.42967. eCollection 2023 Aug.
Obesity is a global health issue, Roux-en-Y gastric bypass (RYGB), is an effective treatment for weight loss. However, some patients experience insufficient weight loss after RYGB, leading to alternative strategies such as adding an adjustable gastric band to the bypass. This case reports a 43-year-old female with morbid obesity who underwent open RYGB in 2004, achieving significant weight loss. However, she experienced weight regain, indicating RYGB failure. A laparoscopic band was placed around her bypass with no post-operative complications and successful steady weight reduction. During follow-up, an upper gastrointestinal series revealed a gastro-gastric fistula. Despite the fistula, the patient maintained a steady weight, with a significant excess weight loss of 40.2% since the banded gastric bypass surgery. The development of a gastro-gastric fistula, which typically affects weight loss outcomes, was managed conservatively without impacting the patient's steady weight maintenance. This highlights an unexpected weight loss outcome in a patient who underwent laparoscopic banding following RYGB failure and later developed a gastro-gastric fistula. Despite the initial RYGB failure, the patient achieved significant weight loss, surpassing the average reported in previous studies.
肥胖是一个全球性的健康问题，胃旁路手术（RYGB）是一种有效的减肥治疗方法。然而，一些患者在接受胃旁路手术后体重减轻不足，导致了诸如在旁路手术中增加可调节胃束带等替代策略。本病例报告了一名43岁的病态肥胖女性，她于2004年接受了开放式胃旁路手术，体重显著减轻。然而，她体重又反弹了，表明胃旁路手术失败。在她的旁路手术周围放置了腹腔镜束带，术后无并发症，体重成功稳步下降。在随访期间，上消化道造影显示存在胃-胃瘘。尽管有瘘管，患者体重仍保持稳定，自束带胃旁路手术后超重体重显著减轻了40.2%。胃-胃瘘的发生通常会影响减肥效果，但通过保守治疗得以控制，并未影响患者体重的稳定维持。这突出了一名在胃旁路手术失败后接受腹腔镜束带手术且后来出现胃-胃瘘的患者出现的意外减肥结果。尽管最初胃旁路手术失败，但患者体重显著减轻，超过了先前研究报告的平均水平。
