الفهرس | Only 14 pages are availabe for public view |
Abstract The incidence of obesity has significantly increased worldwide. Surgery has proven to be the most effective long-term treatment for sustained weight loss and improvement of comorbidities in morbidly obese patients. The MGB overcomes some limitations of the other operations and offers many features of an ideal bariatric operation. The MGB is a short,simple, low-risk operation. It is easily reversed or revised as needed. The underlying cause of bile reflux in MGB can be an ulcer or an abnormal short-length gastric pouch. The most important intervention in these patients is the addition of probiotic foods such as yogurt and avoiding inciting foods such high fat or high volume meals. Often the bile reflux indicates the presence of a marginal ulcer of acid- peptic origin. In these cases, as described above, the treatment is routine for the treatment of any acid-peptic ulcer. In refractory cases (less than 1%) that do not respond to medical management, a side to side Braun jejuno-jejunostomy can be performed. A prospective study of 20 patients who underwent LMGBP in Cairo university hospitals (including New teaching hospital). Patients were invited for an upper GI endoscopy at least 6 months after surgery whether having reflux symptoms or not. Informed consent was obtained from all patients gastric aspirate was assessed for bilirubin level compared to serum bilirubin. Gastric and esophageal Biopsies were taken and submitted for histopathology. Among 20 patients the average EBWL 6 months post operatively is 74% with a minimum of 60% and a maximum of 84% |