Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass

Clin Gastroenterol Hepatol. 2011 Mar;9(3):228-33. doi: 10.1016/j.cgh.2010.11.004. Epub 2010 Nov 17.


Background & aims: Weight regain after Roux-en-Y gastric bypass (RYGB) is associated with reductions in health status and quality of life. We evaluated whether gastrojejunal stoma diameter is a risk factor for weight regain after RYGB.

Methods: We examined data collected over 4 years from consecutive patients referred to a tertiary care bariatric center for upper endoscopy after RYGB. We used linear regression analysis to determine the association between the gastrojejunal stoma diameter and weight regain. We applied a logistic regression model using clinical and endoscopic parameters to develop a prediction rule for weight gain after RYGB.

Results: Among 165 patients included in our study, 59% had significant weight regain (≥ 20% of maximum weight lost after the RYGB) and 41% did not. The mean percentage of maximal weight lost after RYGB that was regained in the entire cohort was 30% ± 22%. Gastrojejunal stoma diameter was associated significantly with weight regain after RYGB surgery in univariate analysis (β = .31, P < .0001). This association remained significant after adjusting for several known or purported risk factors for weight regain (β = .19, P = .003). We developed a simple prediction rule for weight regain after RYGB using a 7-point scoring system that includes the gastrojejunal stoma diameter, race, and percentage of maximal body weight lost after RYGB; a cut-off score of 4 or more points had an area under receiver operating characteristic curve of 0.76 and a positive predictive value of 75%.

Conclusions: Increased gastrojejunal stoma diameter is a risk factor for weight regain after RYGB and can be incorporated in a novel prediction rule.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Endoscopy, Gastrointestinal
  • Female
  • Gastric Bypass*
  • Humans
  • Jejunum / anatomy & histology*
  • Jejunum / pathology
  • Male
  • Obesity / diagnosis*
  • Obesity / prevention & control*
  • Obesity / surgery
  • Prognosis
  • Recurrence
  • Risk Assessment
  • Statistics as Topic
  • Stomach / anatomy & histology*
  • Stomach / pathology
  • Weight Gain*