Results of Gastrojejunal Plication for Inadequate Weight Loss follow Roux-en-Y Gastric Bypass

Background Obesity is a serious global epidemic and poses a significant health threat to humans. The prevalence of obesity is increasing not only in adults, but also among children and adolescents. Non-operative treatment of obesity has commonly been ineffective, and bariatric surgery has been shown to be effective in achieving substantial weight loss and improving obesity related comorbidities in the long-term. Aim of the Work Our objective in this study is to assess the effectiveness of Gastro-jejunal stomal plication (GJP) for inadequate weight loss follow Roux-en-Y gastric bypass surgery (RYGB). Patients and Methods The study will use the following search tools and databases: PubMed, Google Scholar, Cochrane Clinical Trials Database, Cochrane Review Database, EMBASE, and Allied and Complementary Medicine. Search terms included Revisional Surgery, inadequate weight loss And Roux en Y gastric bypass, then gastro-jejunal plication. These studies were published from (2009-2017). Results Eleven studies were included and these studies worked on 420 patients. Comparisons between these were done according to age, sex, time interval between (RYGB) & GJP, weight loss after GJP, laparoscopic vs open technique and overall complications of revisional surgery (GJP). Conclusion The exact reasons for weight loss failure after RYGB remain incompletely elucidated and are probably multifactorial. Pouch resizing could be a valuable option for weight loss failure or regain in selected patients with a dilated gastric pouch after RYGB in the short term. Careful selection of candidates for this procedure through psychiatric and nutritional evaluations and volumetric measures of the gastric pouch, preferably using CT, is mandatory to identify those patients most likely to benefit from revision.