Efficacy of Conversion of Roux-en-Y Gastric Bypass to Roux Jejuno-Duodenostomy for Severe Medically Refractory Postprandial Hypoglycemia
- 1 October 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Obesity Surgery
- Vol. 30 (10), 4141-4144
- https://doi.org/10.1007/s11695-020-04694-y
Abstract
Treatment of medically refractory postprandial hypoglycemia after Roux-en-Y Gastric bypass (RYGB) is often unsuccessful. Various operations have been described with poor results. We describe a novel procedure and retrospective review of 8 patients who underwent Roux jejuno-duodenostomy for postprandial hypoglycemic symptoms refractory to dietary modification and medications. Mean follow-up was 35 months. Complete resolution occurred in two of the patients, marked improvement in four, and no improvement in two. The mean frequency of hypoglycemic symptoms decreased from 30 to 7 episodes per week (p = 0.015). One complication was noted with no mortality. Mean weight decreased postoperatively by 0.8 kg (p = 0.93). Conversion to a Roux jejuno-duodenostomy appears to be a safe and effective treatment with maintenance of post-RYGB weight loss in most such cases.This publication has 9 references indexed in Scilit:
- ASMBS Position Statement on Postprandial Hyperinsulinemic Hypoglycemia after Bariatric SurgerySurgery for Obesity and Related Diseases, 2016
- One-Anastomosis Jejunal Interposition with Gastric Remnant Resection (Branco-Zorron Switch) for Severe Recurrent Hyperinsulinemic Hypoglycemia after Gastric Bypass for Morbid ObesityObesity Surgery, 2016
- Conversion from gastric bypass to sleeve gastrectomy for complications of gastric bypassSurgery for Obesity and Related Diseases, 2016
- Laparoscopic reversal of Roux-en-Y gastric bypass: Technique and utility for treatment of endocrine complicationsSurgery for Obesity and Related Diseases, 2013
- Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass: Unraveling the Role of Gut Hormonal and Pancreatic Endocrine DysfunctionJournal of Surgical Research, 2011
- Reversible Hyperinsulinemic Hypoglycemia after Gastric Bypass: A Consequence of Altered Nutrient DeliveryJournal of Clinical Endocrinology & Metabolism, 2010
- Postgastric bypass hyperinsulinemic hypoglycemia syndrome: characterization and response to a modified dietSurgery for Obesity and Related Diseases, 2008
- Post−Gastric Bypass Hyperinsulinism With Nesidioblastosis: Subtotal or Total Pancreatectomy May Be Needed to Prevent Recurrent HypoglycemiaJournal of Gastrointestinal Surgery, 2006
- Hyperinsulinemic Hypoglycemia with Nesidioblastosis after Gastric-Bypass SurgeryThe New England Journal of Medicine, 2005