Background

Dyspepsia and/or upper abdominal pain is common following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) resulting in many patients remaining on proton pump inhibitors (PPI). Objectives: Determine if laparoscopic vagotomy and hiatal hernia repair with posterior crural repair for LRYGB patients with dyspepsia can improve symptoms and get patients off PPI. Settings: Community hospital, Private Practice

Methods

Retrospective chart review of the first twenty LRYGB patients with dyspepsia or upper abdominal pain treated with laparoscopic vagotomy with hiatal hernia repair between January 2020 and May 2020. Primary Endpoint was complete resolution of symptoms and off PPI. Secondary Endpoints were complications after surgery, length of surgery, and length of hospital stay.

Results

The first twenty patients who underwent truncal vagotomy with hiatal hernia repair were included in the study. Symptoms resolved in 7 (35%), improved in 8 (40%), did not change in 5 (25%), and worsened in 0 (0%). Of the 18 patients on PPIs preoperatively, 10 (55%) were weaned off PPIs and 3 (17%) had a decrease in PPI dose. 3 (15%) patients had postoperative complications due to tight crural closure.

Conclusions

Patients underwent the procedure for multiple etiologies with a common complaint of dyspepsia. Laparoscopic vagotomy and hiatal hernia repair seems to be an effective treatment for LRYGB patients with dyspepsia and/or upper abdominal pain but is associated with risk of complications. This treatment deserves further study with more clearly defined patient subsets.