Reversal of Roux-en-Y anatomy via gastrogastric anastomosis and sleeve gastrectomy for refractory early dumping syndrome: a case report.

IF 0.5 Q4 SURGERY

Journal of Surgical Case Reports Pub Date : 2025-10-09 eCollection Date: 2025-10-01 DOI:10.1093/jscr/rjaf790

Tengfei Qi, Haiyong Ma, Xiaojiang Dai, Longying Wang, Jipei He, Xiaochen Liu, Liangping Wu, Hongbin Zhang

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Abstract

Early dumping syndrome (DS) is a common complication after Roux-en-Y gastric bypass (RYGB), with refractory cases posing significant therapeutic challenges. A 38-year-old male developed severe refractory early DS 2 years post-RYGB, confirmed by modified oral glucose tolerance test meeting Scarpellini 2020 criteria. Symptoms persisted despite maximal dietary and pharmacotherapy (acarbose, somatostatin analogues). The patient underwent laparoscopic gastrogastric anastomosis combined with sleeve gastrectomy -the first reported application for this indication. The Sigstad score decreased from 16 to 6 at 180-day follow-up, indicating complete symptom resolution. Endoscopy and imaging confirmed patent anastomosis without stenosis/leakage, and no complications occurred. This novel combined procedure is a safe and effective solution for refractory early DS post-RYGB, restoring physiological gastric emptying. Long-term outcomes require validation in larger studies.

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胃胃吻合术逆转Roux-en-Y解剖加袖胃切除术治疗难治性早期倾倒综合征1例。

早期倾倒综合征（DS）是Roux-en-Y胃旁路手术（RYGB）后常见的并发症，难治性病例给治疗带来了重大挑战。38岁男性患者，rygb后2年出现严重难治性早期DS，经改良口服糖耐量试验证实符合Scarpellini 2020标准。尽管进行了最大限度的饮食和药物治疗（阿卡波糖、生长抑素类似物），但症状仍然存在。患者行腹腔镜胃吻合术联合袖胃切除术，这是首次报道该指征的应用。在180天的随访中，Sigstad评分从16分下降到6分，表明症状完全缓解。内镜及影像学证实吻合通畅，无狭窄/渗漏，无并发症发生。这种新颖的联合手术是一种安全有效的解决方案，用于难治性早期DS后rygb，恢复生理胃排空。长期结果需要更大规模的研究验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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