Background

There are numerous revisional surgery options for weight regain after Roux-en-Y Gastric Bypass. To date, there are no studies that assess the weight-loss outcomes of concurrent endoscopic revision of the gastrojejunostomy (GJ) in biliopancreatic (BP) limb-lengthening. Herein, we report our experience with single-stage laparoscopic BP limb-lengthening and endoscopic revision of the GJ.

Methods

Five patients from 2021-2023 were included and retrospectively reviewed. The minimum follow-up time was 6 months, with a median follow-up of 16.8 months. In all patients the Roux limb was distalized to allow for a total common channel length of about 150 cm and the endoscopic suturing was used to bring the diameter of the GJ to less than 1 cm.

Results

The average preoperative BMI was 43 with an average excess body weight of 51.5 kg. The mean operative time was 122 + 26.71 min without complications. The BP limb was lengthened by an average of 302 + 50.69 cm. For patients that underwent both laparoscopic and endoscopic revision, the average %EWL was 43.1% with an average BMI change of 7.9 and an average %TWL of 16.3% at a median follow-up of 16.8 months. Overall limb lengths and weight loss outcomes are shown in Figure 1. No readmissions or reinterventions were reported.

Conclusions

ConclusionsSingle-stage laparoscopic Roux limb-lengthening and endoscopic revision of the GJ, seems to be safe and feasible with sustained weight loss at 16.8-month follow-up. Therefore, it should be considered as an effective option of revisional Roux-en-Y Gastric Bypass for weight regain.