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Remnant Gastrectomy and Gastric Bypass: A Systematic Review of Indications and Outcomes of Resectional Gastric Bypass

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Abstract

Background

In this systematic review, we aim to evaluate the reasons and outcomes behind remnant gastrectomy with or after gastric bypass procedures.

Results

A total of 66 studies examining 1918 patients were included in this study with 70% of female predominance. Twenty studies reported RGB on 1751 patients and 46 studies reported remnant gastrectomy after gastric bypass in 167 patients. The most common etiology of RGB was related to the in situ remnant stomach neoplasia in 10 studies on 981 patients; mostly for preventive intentions in high prevalence areas. Remnant gastrectomy after gastric bypass was performed to treat a complication such as GGF, retrograde bile reflux gastritis, cancer mostly adenocarcinoma. Studies revealed that RGB has similar weight loss in comparison to standard Roux-en-Y gastric bypass.

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Acknowledgements

We express our gratitude toward Alireza Pouramini and Mahyaar Omouri for their help and support through this project.

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Authors and Affiliations

  1. Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Rasool-e Akram University Hospital, Iran University of Medical Sciences, Tehran, Iran

    Shahab Shahabi Shahmiri & Mohammad Kermansaravi

  2. Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool University Hospital, Tehran, Iran

    Shahab Shahabi Shahmiri & Mohammad Kermansaravi

  3. Minimally Invasive and Bariatric Surgery Research Center of Rasool-e Akram University Hospital, Iran University of Medical Sciences, Manaouri St., Niyayesh St., Sattar Khan St., Tehran, Iran

    Erfan Sheikhbahaei & Amirhossein Davarpanah Jazi

  4. Minimally Invasive Surgery and Obesity Research Center, School of Medicine, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

    Erfan Sheikhbahaei & Hamidreza Zefreh

  5. Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of **an University, Guangzhou, China

    Wah Yang

  6. The State Key Laboratory of Pharmaceutical Biotechnology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China

    Wah Yang

  7. Urmia University of Medical Sciences, Urmia, Iran

    Rohollah Valizadeh

  8. Hospital Lusiadas Amadora Metabolic Surgery Unit and General Surgery Department Coordinator, Amadora, Portugal

    Rui Ribeiro

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Key Points

• RGB is indicated when there is a risk of gastric malignancy in remnant.

• Fear of remnant stomach-related complications is another reason for RGB.

• RGB has a comparable weight loss similar to RYGB.

• Gastrogastric fistula, bleeding, ulcer, and neoplasia were reasons of secondary RGB.

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Shahabi Shahmiri, S., Sheikhbahaei, E., Davarpanah Jazi, A. et al. Remnant Gastrectomy and Gastric Bypass: A Systematic Review of Indications and Outcomes of Resectional Gastric Bypass. OBES SURG 34, 2634–2649 (2024). https://doi.org/10.1007/s11695-024-07240-2

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