Mini-Gastric Bypass as a Second Bariatric Surgery for Nutritional Problems of Restrictive Surgery

Abstract

Introduction: The failure of restrictive procedures due to problems related to nutritional behavior may necessitate a second bariatric procedure. Solid food intolerance with vomiting&sweet eating are the commonest problems with weight loss life style which in many cases are good enough indications for a second surgery. Method: MGB was performed in 30 consecutive patients with nutritional behavior problems after restrictive surgery. The outcome of surgery was assessed at 3, 6,9&12 months for correction of nutritional behavior problems as well as the BMI&the % excess weight loss. Nutritional deficiencies due to MGB were monitored. Results: Pre-operative nutritional assessment showed an overlap between solid food intolerance, vomiting&sweet eating in 25 patients. MGB was successful in prevention of vomiting, correction of solid food intolerance in 27 out of the study 30 patients. The sweet eating behavior was corrected in all patients but new nutritional problems in the form of dumping, bilious vomiting are reported. Weight loss results were very satisfactory at 12 months. Conclusion: MGB is a good successful second procedure in correction of nutritional problems arising after primary restrictive surgery. Both solid food intolerance&sweet eating are successfully corrected. There is also a very satisfactory improvement in weight loss results.