Roux en Y gastric bypass Surgery

Q) Which  of the following statement about Roux en Y gastric bypass Surgery is not true?

a) After weight loss it resolves symptoms of venous ulcers due to stasis

b) Symptoms of pseudo tumor cerebri are resolved

c) Heartburn is alleviated immediately

d) Protein malnutrition is a very common problem


d ) Protein malnutrition is common in Biliopancreatic division and duodenal switch not in gastric bypass

Essential components of successful Roux en Y gastric bypass are 

  1. Small Gastric pouch (15-20ml). In Roux en Y gastric bypass surgery, gastric pouch is constructed from cardia of the stomach to prevent gastric dilatation and minimize acid production
  2. roux limb length 65-75 cm

After RYGB 90% of patients immediately start to have relief from heartburn and other symptoms mentioned in the question

Saby ref 

Hormonal Response (Very Imp from MCQ point of view) 

  1. Increase Glucagon like peptide (GLP)
  2. Increase Peptide YY
  3. Low Ghrelin

Early complications, within 30 days after surgery 4 % of patients and include bleeding, perforation or leakage,

Late complications such as significant abdominal pain, small bowel obstruction, anastomotic stenosis or marginal ulceration can occur in 15–20 % of patients after 30 days from surgery to over 10 years 

Results

20–30 % long term, over 2 years of weight loss and maintenance 

remission of hypertension, type 2 diabetes mellitus, obstructive sleep apnoea and musculoskeletal pain.

Approximately 40 % of obese patients with type 2 diabetes go into remission within days or weeks after RYGB

REf 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709370/

For In depth bariatric surgery knowledge, try this book Bariatric Surgery Complications and Emergencies

 

Also important points  from bailey, weight loss and diabetic control is highest after BPD and DS, Table 64.5 bailey

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