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Case Reports
. 2021 May;31(5):2353-2355.
doi: 10.1007/s11695-021-05310-3. Epub 2021 Mar 3.

Modified Nissen Fundoplication for Late Dumping Syndrome After Roux-en-Y Gastric Bypass

Joost Maurissen  1 , Nathalie Yercovich  2 , Pieter Van Aelst  2 , Bruno Dillemans  2
Affiliations
Case Reports

Modified Nissen Fundoplication for Late Dumping Syndrome After Roux-en-Y Gastric Bypass

Joost Maurissen et al. Obes Surg. 2021 May.

Abstract

Introduction: Postoperative dumping syndrome (DS) is a common complication after Roux-en-y gastric bypass (RYGB) for morbid obesity. DS is mostly treated conservatively through dietary or pharmacologic measures. In case of non-responding to or contraindication for conservative treatment, surgical intervention may be considered. Various procedures have been described, as there is currently no gold standard technique. We present a new approach by performing a modified Nissen fundoplication.

Case: A 34-year-old female consulted at our outpatient clinic. In her history, she had a laparoscopic RYGB 6 years earlier because of morbid obesity (BMI 37.6 kg/m2). Two years postoperatively, she developed a late DS, for which she was successfully treated with long-acting octreotide. Because of pregnancy wish, octreotide needed to be halted. A laparoscopic modified Nissen fundoplication was performed, creating a cuff around the oesophageal-gastric junction with the fundus of the remnant stomach. This slows down the passage of food through the gastric pouch. Postoperatively, the octreotide treatment was halted without any problems. At 6 months, the patient is still free of dumping complaints.

Discussion: Postoperative DS is a common complication after bariatric surgery. Dietary measures form the first treatment of DS, followed by pharmacologic treatment. Since octreotide is contraindicated in pregnancy, a surgical intervention was opted for. Our case is the first documented modified Nissen fundoplication to treat late postoperative DS after RYGB for morbid obesity.

Conclusion: A laparoscopic modified Nissen fundoplication could be a promising surgical alternative in the treatment of late dumping syndrome after RYGB for morbid obesity.

Keywords: Bariatric surgery; Dumping syndrome; Gastric bypass; Modified Nissen fundoplication; Nissen fundoplication; Obesity; Pregnancy.

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References

    1. Geilswijk M, Andersen LL, Frost M, et al. Octreotide therapy and restricted fetal growth: pregnancy in familial hyperinsulinemic hypoglycemia. Endocrinol Diabetes Metab Case Rep. 2017;2017:16–0126. - PubMed - PMC
    1. Kawahara NT, Alster C, Maluf-Filho F, et al. Modified Nissen fundoplication: laparoscopic antireflux surgery after Roux-en-Y gastric bypass for obesity. Clinics (Sao Paulo). 2012;67(5):531–3. - DOI
    1. Colpaert J, Horevoets J, Maes L, et al. Surgical treatment of therapy-resistant reflux after Roux-en-Y gastric bypass. A case series of the modified Nissen fundoplication. Acta Chir Belg. 2020;120(4):291–6. - DOI
    1. Dillemans B, Sakran N, Van Cauwenberge S, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients. Obes Surg. 2009;19(10):1355–64. - DOI
    1. van Beek AP, Emous M, Laville M, et al. Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management. Obes Rev. 2017;18(1):68–85. - DOI

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