BACKGROUND: Hyperinsulinemic hypoglicemia with severe neuroglycopenic symptoms has been identified as a late and rare complication in patients submitted to Roux-en-Y gastric bypass. However, the potential gravity of its manifestations requires effective treatment of this condition. The absence of treatment makes it necessary to develop more effective clinical or surgical methods. AIM: To present one surgical option to revisional surgery in the treatment of hyperinsulinemic hypoglicemia Methods : The procedure consists in reconstituting alimentary transit through the duodenum and proximal jejunum, while keeping the restrictive part of the gastric bypass. As an additional strategy to maintain weight loss, is realized gastric fundus resection, aiming to suppress ghrelin production more effectively. RESULTS: It was used in three patients with successful results in one year of follow-up. CONCLUSION: The procedure to reconstruct the food transit through the duodenum and proximal jejunum, keeping the restrictive component of gastric bypass in the treatment of hyperinsulinemic hypoglycemia showed good initial results and validated its application in other cases with this indication.
BACKGROUND:Hyperinsulinemic hypoglicemia with severe neuroglycopenic symptoms has been identified as a late and rare complication in patients submitted to Roux-en-Y gastric bypass. However, the potential gravity of its manifestations requires effective treatment of this condition. The absence of treatment makes it necessary to develop more effective clinical or surgical methods. AIM: To present one surgical option to revisional surgery in the treatment of hyperinsulinemic hypoglicemia Methods : The procedure consists in reconstituting alimentary transit through the duodenum and proximal jejunum, while keeping the restrictive part of the gastric bypass. As an additional strategy to maintain weight loss, is realized gastric fundus resection, aiming to suppress ghrelin production more effectively. RESULTS: It was used in three patients with successful results in one year of follow-up. CONCLUSION: The procedure to reconstruct the food transit through the duodenum and proximal jejunum, keeping the restrictive component of gastric bypass in the treatment of hyperinsulinemic hypoglycemia showed good initial results and validated its application in other cases with this indication.
Authors: Anna Christina Charbel Costa; Mariana Camara Martins Bezerra Furtado; Eudes Paiva de Godoy; Elenir Rose Jardim Cury Pontes; João Ricardo Filgueiras Tognini; Maria Lúcia Ivo Journal: Arq Bras Cir Dig Date: 2013-06
Authors: Geoffrey J Service; Geoffrey B Thompson; F John Service; James C Andrews; Maria L Collazo-Clavell; Ricardo V Lloyd Journal: N Engl J Med Date: 2005-07-21 Impact factor: 91.245
Authors: Rodrigo O Moreira; Rustan B M Moreira; Nikolas A M Machado; Tatiana B Gonçalves; Walmir F Coutinho Journal: Obes Surg Date: 2008-06-20 Impact factor: 4.129
Authors: Aluisio Stoll; Jean Carl Silva; Luiz Carlos Von Bahten; Giovana Gugelmin; André Berton Vedan; Bárbara Vicente de Souza Journal: Rev Col Bras Cir Date: 2013 Jan-Feb
Authors: Josemberg M Campos; Daniel C Lins; Lyz B Silva; José Guido C Araujo-Junior; Jorge L M Zeve; Álvaro A B Ferraz Journal: Arq Bras Cir Dig Date: 2013