Conversion of failed Roux-en-Y gastric bypass to biliopancreatic diversion with duodenal switch: outcomes of 9 case series

Halawani, Hamzeh M.; Bonanni, Fernando; Betancourt, Abraham; Antanavicius, Gintaras

doi:10.1016/j.soard.2017.04.021

Cited by 18 publications

(5 citation statements)

References 20 publications

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“…Patients who underwent conversion to BPD/DS from sleeve gastrectomy experienced an additional 41% of excess weight loss (EWL) and 35% remission rate for T2D (21) . Other authors have published success with revsional BPD/DS following RYGB, vertical banded gastroplasty, and laparoscopic adjustable gastric banding (LAGB) (22,23) . A small study of 9 patients who underwent BPD/DS following RYGB found an additional mean EWL of 31±23.1%…”

Section: Introductionmentioning

confidence: 99%

Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel

Merz

Blackstone

Gautier

et al. 2019

Surgery for Obesity and Related Diseases

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Section: Introductionmentioning

confidence: 99%

Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel

Merz

Blackstone

Gautier

et al. 2019

Surgery for Obesity and Related Diseases

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“…Revisional bariatric surgery is a technically demanding super-specialty of metabolic and bariatric surgery associated with higher complication rates and mortality as compared to primary bariatric surgery. The surgical treatment of bariatric emergencies requires a similarly demanding and specialized skill set but has yet to receive wide recognition as a distinct component of metabolic and bariatric surgery [ 7 , 9 , 10 ]. We understand these two disciplines to be uniquely interrelated, with common themes and overlapping knowledge bases.…”

Section: Discussionmentioning

confidence: 99%

“…Mortality rates following revisional gastric sleeve or gastric bypass have been reported at less than 1%, although most of these data are derived from the experience of large academic centers [ 5 , 6 ]. Less clear is the impact of a community hospital setting on outcomes associated with these procedures, although previous evidence has suggested they are comparable [ 7 , 8 ]. On the other hand, very little is also known about the influence of a non-urban, community location on outcomes associated with emergency bariatric operations, even in accredited programs.…”

Section: Introductionmentioning

confidence: 99%

Predictors of morbidity in revisional bariatric surgery and bariatric emergencies at an MBSAQIP-accredited community hospital

et al. 2022

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Introduction Bariatric surgery revisions and emergencies are associated with higher morbidity and mortality compared to primary bariatric surgery. No formal outcome benchmarks exist that distinguish MBSAQIP-accredited centers in the community from unaccredited institutions. Methods A retrospective chart review was conducted on 53 bariatric surgery revisions and 61 bariatric surgical emergencies by a single surgeon at a high-volume community hospital accredited program from 2018 to 2020. Primary outcomes were complications or deaths occurring within 30-days of the index procedure. Secondary outcomes included operative time, leaks, surgical site occurrences (SSOs), and deep surgical site infections. Results There were no significant differences in the demographic characteristics of the study groups. Mean operative time was significantly longer for revisions as compared to emergency operations (149.5 vs. 89.4 min). Emergencies had higher surgical site infection (5.7% vs. 21.3%, p < 0.05) and surgical site occurrence (SSO) (1.9% vs. 29.5%, p < 0.05) rates compared to revisions. Logistic regression analysis identified several factors to be predictive of increased risk of morbidity: pre-operative albumin < 3.5 g/dL (p < 0.05), recent bariatric procedure within the last 30 days (p < 0.05), prior revisional bariatric surgery (p < 0.05), prior duodenal switch (p < 0.05), and pre-operative COPD (p < 0.05). Conclusion Bariatric surgery revisions and emergencies have similar morbidity and mortality, far exceeding those of the primary operation. Outcomes comparable to those reported by urban academic centers can be achieved in community hospital MBSAQIP-accredited centers.

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“…The most widely used options after RYGB is the conversion to a long-limb (distal) RYGB, pouch resizing, banding of the pouch or endoscopic narrowing of the pouch anastomosis (176,177,178). However, the conversion of the failed RYGB to BPD-DS have also been successfully reported in two case series (179,180). The outcomes of these revisions are in the short term acceptable but there are only few long-term results.…”

Section: Discussionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Which metabolic procedure? Comparing outcomes in sleeve gastrectomy and Roux-en Y gastric bypass

Billeter

Herrera

Scheurlen

et al. 2018

European Journal of Endocrinology

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Obesity and its associated comorbidities have become one of the largest challenges for health care in the near future. Conservative therapy for obesity and related comorbidities has a very high failure rate and poor long-term results. Similarly, the conservative and medical management of the majority of metabolic diseases such as type 2 diabetes mellitus are only able to slow down disease progression but have no causal effect on the disease process. Obesity surgery has evolved as a highly effective therapy for severe obesity achieving long-lasting weight loss. Furthermore, several studies have demonstrated the beneficial effects of obesity surgery on reduction of overall mortality, reduction of cardiovascular events and superior control of obesity-related diseases such as type 2 diabetes mellitus, dyslipidemia and also the non-alcoholic steatohepatitis compared to medical therapy. Based on these findings, the term 'metabolic surgery' with the focus on treating metabolic diseases independent of body weight has been coined. Of great interest are recent studies that show that even existing complications of metabolic diseases such as diabetic nephropathy or the non-alcoholic steatohepatitis can be reversed by metabolic surgery. Although metabolic surgery has proven to be a safe and effective treatment for obesity, resolution of comorbidities and enhancing quality of life, it is still uncertain and unclear, which surgical procedure is the most effective to achieve these metabolic effects. The aim of this review is to compare the effects of the two currently most widely used metabolic operations, the Roux-en-Y gastric bypass and the sleeve gastrectomy in the treatment of obesity and its related comorbidities.

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Conversion of failed Roux-en-Y gastric bypass to biliopancreatic diversion with duodenal switch: outcomes of 9 case series

Cited by 18 publications

References 20 publications

Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel

Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel

Predictors of morbidity in revisional bariatric surgery and bariatric emergencies at an MBSAQIP-accredited community hospital

MANAGEMENT OF ENDOCRINE DISEASE: Which metabolic procedure? Comparing outcomes in sleeve gastrectomy and Roux-en Y gastric bypass

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