Gastric Bypass After Gastric Sleeve: Complications

Question Below Submitted By:  

Cheryl K. (a patient from Las Vegas, Nevada)

In September of 2012 I had Gastric Sleeve Surgery but dealt with severe Acid Reflux. My Bariatric Surgeon did two Endoscopies to see if the opening needed to be unblocked and we tried several antacid medications, but they did not work.

After I would eat, the reflux would start and it was so bad that it would feel like an elephant was sitting on my chest.

The surgeon’s suggestion was to do Gastric Bypass Surgery over the Sleeve surgery. But he had told me that he had never done it before and he has done over 8000 surgeries. We discussed the risks and I got a second opinion from another Bariatric Surgeon who said BYPASS was the only way to get rid of the reflux.

After several months of thinking about all of the risks and dealing with being sick (vomiting) all the time I finally said okay and he did the Gastric Bypass surgery in June of 2013.

One week after that surgery I was rushed into the hospital as a severe infection had set in and burst open. The hospital I was rushed into could not take me into surgery because I was a week out of my doctors surgery, so I was sent back to his hospital and he opened the incision in my room for it to drain.

But I was also in the care of Infectious Disease Doctors because the infection was Streptococcus and it was 5 and 3/8 inches down in my system. I had to go home with a Pic line and do IV treatment at home for three weeks before the line was taken out. But that incision never closed completely and he had to do surgery again on the incision to close it.

This past January I had Gallbladder surgery which was contracted and could not be found by a Hida Scan. The General Surgeon found it tucked under my liver and ever since then I have been sick.

What I really need to know is, has a Gastric Bypass ever been done over a Gastric Sleeve surgery and if so what kind of complications are there?

I am still having problems with eating and do not eat 4 ounces of food per meal. If I am lucky it maybe 1-2 ounces and I may keep it down.

There have been 5 endoscopies and to no end nothing ever shows a blockage. Just had an Upper GI and it was clear.

Please help me. I have lost 200 pounds since 9/2012 but can not take or handle not being able to eat like I should. I basically live on Protein Shakes and Protein soups. Please tell me if you know what the problem could be.


Expert Responses to the Question Above

Surgeon response to "Gastric Bypass After Gastric Sleeve: Complications"

by: John Rabkin, M.D., Pacific Laparoscopy


You have had a most difficult journey after your bariatric surgical procedures!

However, what you have experienced, although unusual, is not without precedent.

First of all, the Verticle Sleeve Gastrectomy (VSG) is considered a "high pressure" gastric procedure that has been demonstrated to increase the reflux symptoms in many patients.

Patients who have severe reflux after the VSG as you experienced often enjoy significant relief of that symptom after undergoing a conversion from a VSG to a Roux-en-Y Gastric Bypass (RGB).

This is due to the fact that the gastric pouch is no longer in continuity with the distal stomach and the pylorus which, as a consequence, decreases the esophagus' exposure to acid secretions (reflux).

This approach is not unusual and there are many people like yourself who have been managed in this way.

The wound infection(s) that you suffered after the conversion surgery are not related specifically to the procedure that you underwent but, instead, is a known potential complication of any surgical procedure.

Your current 'intolerance' to eating a meal is an expected result after the RGB.

The gastric pouch is intentionally constructed to limit your ability to consume large quantities of food at a single meal: one to two ounces of food would be all that you should expect to be able to eat at a single time.

Furthermore, I would encourage you to limit your liquid caloric intake to prevent weight regain unless you need the liquid protein to maintain your body at a healthy weight and nutritional state.

If you haven't already reviewed your concerns with your bariatric surgeon, I encourage you to do so.

If there is a bariatric support group with people who have undergone the RGB that you can participate in and you haven't done so, I believe that you will derive valuable information that will assist you in your weight loss journey.

Best regards,

John Rabkin,
M.D. Pacific Laparoscopy

(click here for Dr. Rabkin's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Complications & Risks of Gastric Sleeve Surgery
- Bariatric Diet (What you eat)
- Bariatric Eating (How you eat)

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