Background: Vertical banded gastroplasty (VBG) is sometimes associated with gastroesophageal reflux disease (GERD) and long-time failure in weight loss. This situation is a problem; one therapeutic option is a Roux-en-Y gastric bypass (RYGBP).
Objective: To analyze the perspective of laparoscopic surgical treatment in a patient with persistent GERD after traditional bariatric surgery for morbid obesity management.
Case Report: A 48-year-old woman with morbid obesity, body mass index (BMI) of 46 kg/m(2), and high blood pressure underwent VBG (open surgery, Mason's technique) in 1996 and decreased her BMI to 32 kg/m(2). Six years after initial surgery, she developed severe GERD resistant to medical treatment (omeprazol 80 mg/day) that was confirmed by 24-h esophageal pH monitoring (48 DeMeester normal) and esophageal manometry (low esophageal sphincter pressure) 5 mmHg). During these years, she increased BMI from 32 kg/m(2) to 40 kg/m(2). Laparoscopic conversion to RYGBP was performed.
Results: Postoperative evolution was satisfactory with disappearance of GERD. Control 24-h esophageal pH monitoring reported 4 DeMeester normal. At 12-month follow-up, she decreased BMI to 27 kg/m(2).
Conclusions: Laparoscopic reoperative RYGBP is a viable surgical option in GERD treatment and obesity control.
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