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NCT01040377

Laparoscopic Revision Gastric Bypass for Inadequate Initial Weight Loss

Last Updated: 2009-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

42 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-10-31

Study Completion Date

2009-12-31

Brief Summary

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The main aim of this study is to analyze and report traditional, patient-centered, and composite intermediate-term outcomes after laparoscopic revision Roux-en-Y gastric bypass surgery for inadequate initial weight loss.

Detailed Description

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There is lack of standardization of primary and revisional bariatric surgery compounded by a scant long-term outcome data. The treatment of inadequate weight loss, weight recidivism, and most severe technical complications after primary bariatric surgery remains refractory to non-operative treatment. Failure rates have been reported up to 20% and 35% for the morbidly obese (MO) and super obese (SO), respectively at 2 to 3 years after surgery. The indication for further surgical intervention remains controversial, as does what type of revisional procedure, both operative and endoscopic, to recommend. Furthermore, there is no standardization of the limb lengths, pouch size or the use of prosthetic reinforcement. Therefore the approach to these patients must be as individualized as their original operations. We formally analyze our experience with all laparoscopic revisional strategies for Inadequate Initial Weight Loss after failed Roux-en-Y gastric bypass(RYGB).

Conditions

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Inadequate Initial Weight Loss Persistent Clinically Severe Obesity

Keywords

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Inadequate Initial Weight Loss Inadequate weight loss Poor weight loss Failed gastric bypass Revision gastric bypass

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Inadequate initial weight loss after gastric bypass

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* laparoscopic revisional RYGB for failed RYGB with IIWL or non-responders pattern

Exclusion Criteria

* failed RYGB with a WR pattern
* patients with prior major bariatric conversion or esophago-gastric surgeries
* RYGB patients revised by an open surgical approach
* RYGB patients who underwent laparoscopic revisional RYGB surgery somewhere else and continue their follow-up care with program
* missing records and/or unreachable patients with scan information for analysis

Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Responsible Party

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UCSF Fresno / ALSA Medical Group, Inc. Minimally Invasive Surgery Program

Principal Investigators

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Francisco M Tercero, MD

Role: STUDY_DIRECTOR

Research Associate, University of California San Franisco

Kelvin D Higa, MD

Role: PRINCIPAL_INVESTIGATOR

Professor of Surgery, University of California San Francisco

Locations

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UCSF Fresno Center for Medical Education and Research

Fresno, California, United States

Site Status

Countries

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United States

References

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Higa KD, Boone KB, Ho T, Davies OG. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 2000 Sep;135(9):1029-33; discussion 1033-4. doi: 10.1001/archsurg.135.9.1029.

Reference Type BACKGROUND

PMID: 10982506 (View on PubMed)

Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004 Jun 16;291(23):2847-50. doi: 10.1001/jama.291.23.2847.

Reference Type BACKGROUND

PMID: 15199035 (View on PubMed)

Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999 Oct 7;341(15):1097-105. doi: 10.1056/NEJM199910073411501.

Reference Type BACKGROUND

PMID: 10511607 (View on PubMed)

McTigue KM, Harris R, Hemphill B, Lux L, Sutton S, Bunton AJ, Lohr KN. Screening and interventions for obesity in adults: summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2003 Dec 2;139(11):933-49. doi: 10.7326/0003-4819-139-11-200312020-00013.

Reference Type BACKGROUND

PMID: 14644897 (View on PubMed)

Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724-37. doi: 10.1001/jama.292.14.1724.

Reference Type BACKGROUND

PMID: 15479938 (View on PubMed)

Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, MacLean LD. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004 Sep;240(3):416-23; discussion 423-4. doi: 10.1097/01.sla.0000137343.63376.19.

Reference Type BACKGROUND

PMID: 15319713 (View on PubMed)

Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007 Aug 23;357(8):753-61. doi: 10.1056/NEJMoa066603.

Reference Type BACKGROUND

PMID: 17715409 (View on PubMed)

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Reference Type BACKGROUND

PMID: 17715408 (View on PubMed)

Cremieux PY, Buchwald H, Shikora SA, Ghosh A, Yang HE, Buessing M. A study on the economic impact of bariatric surgery. Am J Manag Care. 2008 Sep;14(9):589-96.

Reference Type BACKGROUND

PMID: 18778174 (View on PubMed)

Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005 Oct 19;294(15):1909-17. doi: 10.1001/jama.294.15.1909.

Reference Type BACKGROUND

PMID: 16234497 (View on PubMed)

Flum DR, Khan TV, Dellinger EP. Toward the rational and equitable use of bariatric surgery. JAMA. 2007 Sep 26;298(12):1442-4. doi: 10.1001/jama.298.12.1442. No abstract available.

Reference Type BACKGROUND

PMID: 17895461 (View on PubMed)

Meguid MM, Glade MJ, Middleton FA. Weight regain after Roux-en-Y: a significant 20% complication related to PYY. Nutrition. 2008 Sep;24(9):832-42. doi: 10.1016/j.nut.2008.06.027.

Reference Type BACKGROUND

PMID: 18725080 (View on PubMed)

Nguyen NT. Reoperations and revisions in bariatric surgery. Surg Endosc. 2007 Nov;21(11):1907-8. doi: 10.1007/s00464-007-9572-6. Epub 2007 Sep 8. No abstract available.

Reference Type BACKGROUND

PMID: 17828427 (View on PubMed)

www.asbs.org/htm/Private/resolution.html. American Society of Metabolic and Bariatric Surgery.

Reference Type BACKGROUND

O'Brien PE, McPhail T, Chaston TB, Dixon JB. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006 Aug;16(8):1032-40. doi: 10.1381/096089206778026316.

Reference Type BACKGROUND

PMID: 16901357 (View on PubMed)

Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, deRamon RA, Israel G, Dolezal JM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995 Sep;222(3):339-50; discussion 350-2. doi: 10.1097/00000658-199509000-00011.

Reference Type BACKGROUND

PMID: 7677463 (View on PubMed)

Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006 Nov;244(5):734-40. doi: 10.1097/01.sla.0000217592.04061.d5.

Reference Type BACKGROUND

PMID: 17060766 (View on PubMed)

Sarr MG. Reoperative bariatric surgery. Surg Endosc. 2007 Nov;21(11):1909-13. doi: 10.1007/s00464-007-9536-x. Epub 2007 Aug 19. No abstract available.

Reference Type BACKGROUND

PMID: 17705073 (View on PubMed)

Schwartz RW, Strodel WE, Simpson WS, Griffen WO Jr. Gastric bypass revision: lessons learned from 920 cases. Surgery. 1988 Oct;104(4):806-12.

Reference Type BACKGROUND

PMID: 3051478 (View on PubMed)

Khaitan L, Van Sickle K, Gonzalez R, Lin E, Ramshaw B, Smith CD. Laparoscopic revision of bariatric procedures: is it feasible? Am Surg. 2005 Jan;71(1):6-10; discussion 10-2.

Reference Type BACKGROUND

PMID: 15757050 (View on PubMed)

Roberts K, Duffy A, Kaufman J, Burrell M, Dziura J, Bell R. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007 Aug;21(8):1397-402. doi: 10.1007/s00464-007-9232-x. Epub 2007 Mar 1.

Reference Type BACKGROUND

PMID: 17332953 (View on PubMed)

Madan AK, Tichansky DS, Phillips JC. Does pouch size matter? Obes Surg. 2007 Mar;17(3):317-20. doi: 10.1007/s11695-007-9058-6.

Reference Type BACKGROUND

PMID: 17546838 (View on PubMed)

Muller MK, Wildi S, Scholz T, Clavien PA, Weber M. Laparoscopic pouch resizing and redo of gastro-jejunal anastomosis for pouch dilatation following gastric bypass. Obes Surg. 2005 Sep;15(8):1089-95. doi: 10.1381/0960892055002257.

Reference Type BACKGROUND

PMID: 16197777 (View on PubMed)

Patel RA, Brolin RE, Gandhi A. Revisional operations for marginal ulcer after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009 May-Jun;5(3):317-22. doi: 10.1016/j.soard.2008.10.011. Epub 2008 Nov 6.

Reference Type BACKGROUND

PMID: 19136312 (View on PubMed)

Fobi MA, Lee H, Felahy B, Che K, Ako P, Fobi N. Choosing an operation for weight control, and the transected banded gastric bypass. Obes Surg. 2005 Jan;15(1):114-21. doi: 10.1381/0960892052993404.

Reference Type BACKGROUND

PMID: 15760509 (View on PubMed)

Capella JF, Capella RF. An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. Am J Surg. 2002 Feb;183(2):117-23. doi: 10.1016/s0002-9610(01)00871-6.

Reference Type BACKGROUND

PMID: 11918873 (View on PubMed)

White S, Brooks E, Jurikova L, Stubbs RS. Long-term outcomes after gastric bypass. Obes Surg. 2005 Feb;15(2):155-63. doi: 10.1381/0960892053268282.

Reference Type BACKGROUND

PMID: 15802056 (View on PubMed)

Bessler M, Daud A, Kim T, DiGiorgi M. Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results. Surg Obes Relat Dis. 2007 Jul-Aug;3(4):480-4; discussion 484-5. doi: 10.1016/j.soard.2007.01.010. Epub 2007 Jun 4.

Reference Type BACKGROUND

PMID: 17544335 (View on PubMed)

Z'graggen K, Guweidhi A, Steffen R, Potoczna N, Biral R, Walther F, Komminoth P, Horber F. Severe recurrent hypoglycemia after gastric bypass surgery. Obes Surg. 2008 Aug;18(8):981-8. doi: 10.1007/s11695-008-9480-4. Epub 2008 Apr 26.

Reference Type BACKGROUND

PMID: 18438618 (View on PubMed)

Dapri G, Cadiere GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-Y gastric bypass. Obes Surg. 2009 May;19(5):650-4. doi: 10.1007/s11695-009-9807-9. Epub 2009 Mar 5.

Reference Type BACKGROUND

PMID: 19263180 (View on PubMed)

Kyzer S, Raziel A, Landau O, Matz A, Charuzi I. Use of adjustable silicone gastric banding for revision of failed gastric bariatric operations. Obes Surg. 2001 Feb;11(1):66-9. doi: 10.1381/096089201321454132.

Reference Type BACKGROUND

PMID: 11361171 (View on PubMed)

Bessler M, Daud A, DiGiorgi MF, Olivero-Rivera L, Davis D. Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg. 2005 Nov-Dec;15(10):1443-8. doi: 10.1381/096089205774859173.

Reference Type BACKGROUND

PMID: 16354525 (View on PubMed)

Gobble RM, Parikh MS, Greives MR, Ren CJ, Fielding GA. Gastric banding as a salvage procedure for patients with weight loss failure after Roux-en-Y gastric bypass. Surg Endosc. 2008 Apr;22(4):1019-22. doi: 10.1007/s00464-007-9609-x. Epub 2007 Oct 18.

Reference Type BACKGROUND

PMID: 17943353 (View on PubMed)

Chin PL, Ali M, Francis K, LePort PC. Adjustable gastric band placed around gastric bypass pouch as revision operation for failed gastric bypass. Surg Obes Relat Dis. 2009 Jan-Feb;5(1):38-42. doi: 10.1016/j.soard.2008.08.012. Epub 2008 Aug 22.

Reference Type BACKGROUND

PMID: 18996754 (View on PubMed)

Mouiel J, Bourg S, Iannelli A, et al. Nouvelle technique de gastroplatie verticale calibree type Mason-MacLean avec cure de reflux gastro-oesophagien. Jornal de Coelio Chirurgie 2001;38: 53-6.

Reference Type BACKGROUND

Fedenko V, Evdoshenko V. Antireflux sleeve gastroplasty: description of a novel technique. Obes Surg. 2007 Jun;17(6):820-4. doi: 10.1007/s11695-007-9124-0.

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PMID: 17879584 (View on PubMed)

Brolin RE, Kenler HA, Gorman JH, Cody RP. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992 Apr;215(4):387-95. doi: 10.1097/00000658-199204000-00014.

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PMID: 1558421 (View on PubMed)

MacLean LD, Rhode BM, Nohr CW. Long- or short-limb gastric bypass? J Gastrointest Surg. 2001 Sep-Oct;5(5):525-30. doi: 10.1016/s1091-255x(01)80091-3.

Reference Type BACKGROUND

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PMID: 12194548 (View on PubMed)

Lee S, Sahagian KG, Schriver JP. Relationship between varying Roux limb lengths and weight loss in gastric bypass. Curr Surg. 2006 Jul-Aug;63(4):259-63. doi: 10.1016/j.cursur.2006.05.001.

Reference Type BACKGROUND

PMID: 16843777 (View on PubMed)

Ciovica R, Takata M, Vittinghoff E, Lin F, Posselt AM, Rabl C, Stein HJ, Campos GM. The impact of roux limb length on weight loss after gastric bypass. Obes Surg. 2008 Jan;18(1):5-10. doi: 10.1007/s11695-007-9312-y. Epub 2007 Dec 7.

Reference Type BACKGROUND

PMID: 18064526 (View on PubMed)

Bruder SJ, Freeman JB, Brazeau-Gravelle P. Lengthening the Roux-Y Limb Increases Weight Loss after Gastric Bypass: a preliminary report. Obes Surg. 1991 Mar;1(1):73-77. doi: 10.1381/096089291765561501.

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PMID: 10715665 (View on PubMed)

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PMID: 9730521 (View on PubMed)

Feng JJ, Gagner M, Pomp A, Korgaonkar NM, Jacob BP, Chu CA, Voellinger DC, Quinn T, Herron DM, Inabnet WB. Effect of standard vs extended Roux limb length on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2003 Jul;17(7):1055-60. doi: 10.1007/s00464-002-8933-4. Epub 2003 May 6.

Reference Type BACKGROUND

PMID: 12728380 (View on PubMed)

Inabnet WB, Quinn T, Gagner M, Urban M, Pomp A. Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths. Obes Surg. 2005 Jan;15(1):51-7. doi: 10.1381/0960892052993468.

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PMID: 15760498 (View on PubMed)

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Fobi MA, Lee H, Igwe D Jr, Felahy B, James E, Stanczyk M, Tambi J, Eyong P. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg. 2001 Apr;11(2):190-5. doi: 10.1381/096089201321577866.

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Sapala JA, Wood MH, Sapala MA, Schuhknecht MP, Flake TM Jr. The micropouch gastric bypass: technical considerations in primary and revisionary operations. Obes Surg. 2001 Feb;11(1):3-17. doi: 10.1381/096089201321454042.

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Brolin RE, Cody RP. Adding malabsorption for weight loss failure after gastric bypass. Surg Endosc. 2007 Nov;21(11):1924-6. doi: 10.1007/s00464-007-9542-z. Epub 2007 Sep 3.

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PMID: 17768659 (View on PubMed)

Pareja JC, Pilla VF, Callejas-Neto F, Coelho-Neto Jde S, Chaim EA, Magro DO. [Gastric bypass Roux-en-Y gastrojejunostomy--conversion to distal gastrojejunoileostomy for weight loss failure--experience in 41 patients]. Arq Gastroenterol. 2005 Oct-Dec;42(4):196-200. doi: 10.1590/s0004-28032005000400002. Epub 2006 Jan 19. Portuguese.

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Faintuch J, Matsuda M, Cruz ME, Silva MM, Teivelis MP, Garrido AB Jr, Gama-Rodrigues JJ. Severe protein-calorie malnutrition after bariatric procedures. Obes Surg. 2004 Feb;14(2):175-81. doi: 10.1381/096089204322857528.

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Spaulding L, Osler T, Patlak J. Long-term results of sclerotherapy for dilated gastrojejunostomy after gastric bypass. Surg Obes Relat Dis. 2007 Nov-Dec;3(6):623-6. doi: 10.1016/j.soard.2007.07.009. Epub 2007 Oct 23.

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Mikami D, Needleman B, Narula V, Durant J, Melvin WS. Natural orifice surgery: initial US experience utilizing the StomaphyX device to reduce gastric pouches after Roux-en-Y gastric bypass. Surg Endosc. 2010 Jan;24(1):223-8. doi: 10.1007/s00464-009-0640-y. Epub 2009 Jul 25.

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Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.

Reference Type BACKGROUND

PMID: 15273542 (View on PubMed)

Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003 Apr;13(2):159-60. doi: 10.1381/096089203764467117. No abstract available.

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PMID: 12760387 (View on PubMed)

Oria HE, Moorehead MK. Updated Bariatric Analysis and Reporting Outcome System (BAROS). Surg Obes Relat Dis. 2009 Jan-Feb;5(1):60-6. doi: 10.1016/j.soard.2008.10.004. Epub 2008 Nov 1.

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PMID: 19161935 (View on PubMed)

Majani G, Pierobon A, Giardini A, et al. Satisfaction Profile (SAT-P) in 732 patients: focus on subjectivity in HRQoL assessment. Psychol Health 2000; 15: 409-22.

Reference Type BACKGROUND

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

U1111-1113-0264

Identifier Type: OTHER

Identifier Source: secondary_id

CMC IRB No. 2009077

Identifier Type: -

Identifier Source: org_study_id

Laparoscopic Revision Gastric Bypass for Inadequate Initial Weight Loss

Study Results

Basic Information

Brief Summary

Detailed Description

Conditions

Keywords

Study Design

Study Groups

Inadequate initial weight loss after gastric bypass

Eligibility Criteria

Inclusion Criteria

Exclusion Criteria

Sponsors

University of California, San Francisco

Responsible Party

Principal Investigators

Francisco M Tercero, MD

Kelvin D Higa, MD

Locations

UCSF Fresno Center for Medical Education and Research

Countries

References

Higa KD, Boone KB, Ho T, Davies OG. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 2000 Sep;135(9):1029-33; discussion 1033-4. doi: 10.1001/archsurg.135.9.1029.

Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004 Jun 16;291(23):2847-50. doi: 10.1001/jama.291.23.2847.

Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999 Oct 7;341(15):1097-105. doi: 10.1056/NEJM199910073411501.

McTigue KM, Harris R, Hemphill B, Lux L, Sutton S, Bunton AJ, Lohr KN. Screening and interventions for obesity in adults: summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2003 Dec 2;139(11):933-49. doi: 10.7326/0003-4819-139-11-200312020-00013.

Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724-37. doi: 10.1001/jama.292.14.1724.

Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, MacLean LD. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004 Sep;240(3):416-23; discussion 423-4. doi: 10.1097/01.sla.0000137343.63376.19.

Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007 Aug 23;357(8):753-61. doi: 10.1056/NEJMoa066603.

Cremieux PY, Buchwald H, Shikora SA, Ghosh A, Yang HE, Buessing M. A study on the economic impact of bariatric surgery. Am J Manag Care. 2008 Sep;14(9):589-96.

Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005 Oct 19;294(15):1909-17. doi: 10.1001/jama.294.15.1909.

Flum DR, Khan TV, Dellinger EP. Toward the rational and equitable use of bariatric surgery. JAMA. 2007 Sep 26;298(12):1442-4. doi: 10.1001/jama.298.12.1442. No abstract available.

Meguid MM, Glade MJ, Middleton FA. Weight regain after Roux-en-Y: a significant 20% complication related to PYY. Nutrition. 2008 Sep;24(9):832-42. doi: 10.1016/j.nut.2008.06.027.

Nguyen NT. Reoperations and revisions in bariatric surgery. Surg Endosc. 2007 Nov;21(11):1907-8. doi: 10.1007/s00464-007-9572-6. Epub 2007 Sep 8. No abstract available.

www.asbs.org/htm/Private/resolution.html. American Society of Metabolic and Bariatric Surgery.

O'Brien PE, McPhail T, Chaston TB, Dixon JB. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006 Aug;16(8):1032-40. doi: 10.1381/096089206778026316.

Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006 Nov;244(5):734-40. doi: 10.1097/01.sla.0000217592.04061.d5.

Sarr MG. Reoperative bariatric surgery. Surg Endosc. 2007 Nov;21(11):1909-13. doi: 10.1007/s00464-007-9536-x. Epub 2007 Aug 19. No abstract available.

Schwartz RW, Strodel WE, Simpson WS, Griffen WO Jr. Gastric bypass revision: lessons learned from 920 cases. Surgery. 1988 Oct;104(4):806-12.

Khaitan L, Van Sickle K, Gonzalez R, Lin E, Ramshaw B, Smith CD. Laparoscopic revision of bariatric procedures: is it feasible? Am Surg. 2005 Jan;71(1):6-10; discussion 10-2.

Roberts K, Duffy A, Kaufman J, Burrell M, Dziura J, Bell R. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007 Aug;21(8):1397-402. doi: 10.1007/s00464-007-9232-x. Epub 2007 Mar 1.

Madan AK, Tichansky DS, Phillips JC. Does pouch size matter? Obes Surg. 2007 Mar;17(3):317-20. doi: 10.1007/s11695-007-9058-6.

Muller MK, Wildi S, Scholz T, Clavien PA, Weber M. Laparoscopic pouch resizing and redo of gastro-jejunal anastomosis for pouch dilatation following gastric bypass. Obes Surg. 2005 Sep;15(8):1089-95. doi: 10.1381/0960892055002257.

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