Conversions of Roux-en-Y gastric bypass to duodenal switch (SADI-S and BPD-DS) for weight regain

Moon, Rena; Alkhairi, Layth; Wier, Alyssa Jameson; Teixeira, André; Jawad, Muhammad A.

doi:10.1007/s00464-019-07219-6

Cited by 32 publications

(14 citation statements)

References 19 publications

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“…Roux-en-Y gastric bypass (RYGB) [6], while patients with weight regain or insufficient weight loss may profit from a more malabsorptive procedure such as one-anastomosis gastric bypass (OAGB) or single-anastomosis duodeno-ileal bypass + sleeve gastrectomy (SADI-S) [7,8]. Further options are laparoscopic re-sleeve [9] or the use of endoscopic suturing devices [10] to re-increase the restriction of the sleeve, which will not be addressed in any detail in this paper, as these procedures were not performed in the present cohort.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Sleeve Gastrectomy Converted to Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

et al. 2022

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Purpose Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide but there is also a high conversion rate mainly due to weight regain and gastroesophageal reflux disease (GERD) reported in studies with long-term follow-up. The aim of this study is to highlight benefits and limitations of converting SG patients to Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB). Setting Retrospective cross-sectional-study, medical university clinic setting. Methods This study includes all patients converted from primary SG to RYGB or OAGB by 12/2018 at the Medical University of Vienna. Patients were examined using gastroscopy, esophageal manometry, 24-h pH-metry, and questionnaires. Results Fifty-eight patients were converted from SG to RYGB (n = 45) or OAGB (n = 13). Total weight loss of patients converted to RYGB and OAGB was 41.5% and 44.8%, respectively, at nadir. Six patients had Barrett’s esophagus (BE) after SG. In four out of these six patients, a complete remission of BE after conversion to RYGB was observed; nevertheless, two patients after RYGB and one after OABG newly developed BE. Clinical GERD improved at a higher rate after RYGB than after OAGB. Both revisional procedures improved associated medical problems. Conclusion Conversion to RYGB is probably the best option for patients with GERD after SG. OAGB has shown a low potential to cure patients from GERD symptoms after SG. In terms of additional weight loss and remission of associated medical problems, both procedures studied were equal. Surveillance gastroscopies every 5 years after SG revisions are recommended. Graphical abstract

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Section: Introductionmentioning

confidence: 99%

Outcome of Sleeve Gastrectomy Converted to Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

et al. 2022

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“…Conversion of gastric bypass to BPD-DS is generally considered safe among experienced surgeons [1]. However, conversions carry greater risks than primary procedures and devastating complications can still occur [2].…”

Section: Discussionmentioning

confidence: 99%

“…Conversion of Roux-en-Y gastric bypass (RYGB) to biliopancreatic diversion with duodenal switch (BPD-DS) is one of the options for RYGB patients who fail to lose sufficient weight or weight gain [1,2] The conversion can be done in a single or staged approach which is dependent on surgeon preference and patient factors [1]. While the conversion can be performed relatively safely through experienced hands, it still carries complication risks [3].…”

Section: Introductionmentioning

confidence: 99%

Necrotizing Fasciitis and Barotrauma-Induced Pneumatocele Following Conversion of Gastric Bypass to Duodenal Switch: A Case Report

Jawad¹

2020

IJCCR

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Conversion of Roux-en-Y gastric bypass (RYGB) to biliopancreatic diversion with duodenal switch (BPD-DS) is one of the options for RYGB patients who fail to lose sufficient weight or weight gain.The conversion can be done in a single or staged approach which is dependent on surgeon preference and patient factors. While the conversion can be performed relatively safely through experienced hands, it still carries complication risks. The risks associated with the conversion are similar to those of primary BPD-DS and include anastomotic leak, bleeding, bowel obstruction, stricture of the gastro-jejunal anastomosis, wound infection, and deep vein thrombosis. We present a case of a single stage conversion of RYBG to BPD-DS which was complicated by necrotizing fasciitis of the abdominal wall and barotrauma-induced pneumatocele.

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“…After BPD-DS, one patient developed malnutrition and required to increase the common channel for 20 months due to persistent malnutrition and diarrhea. 40 In another retrospective study, 12 consecutive patients underwent a BPD-DS after RYGB. Eleven months after surgery, pre-revision mean BMI decreased from 40.7 to 30.7 kg/m 2 .…”

Section: Revision Of Rygb To Sadi-s or Bpd-dsmentioning

confidence: 99%

Interventions for Weight Regain after Bariatric Surgery

Muñóz

Soto

2021

Digestive Disease Interventions

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Bariatric surgery is the most effective available treatment for obesity, inducing a significant and durable weight loss, and improving several obesity-associated diseases. However, as the number of bariatric surgeries performed increases, so does the prevalence of patients who experience either insufficient weight loss or weight regain, accompanied by relapse or the emergence of new obesity-related diseases. Endoscopic and surgical bariatric revisional procedures are used to promote weight loss and improve metabolic function to address these problems. After a psychological, nutritional, medical, and anatomical evaluation of the gastrointestinal anatomy has been completed, patient candidacy to a revisional procedure must be defined. In those patients with insufficient weight loss or weight regain associated with relapse, the emergence of new obesity-related diseases, or quality-of-life deterioration, a revisional procedure must be selected. Although current evidence comes mainly from observational and retrospective studies, with a limited number of patients and short follow-up times, the available data indicate that revisional procedures are useful to induce a significant weight loss and/or promote remission of obesity-associated diseases, albeit an increased risk of surgical and/or nutritional complications. Thus, careful selection of patients is needed to minimize risk and maximize the benefit of these procedures.

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Conversions of Roux-en-Y gastric bypass to duodenal switch (SADI-S and BPD-DS) for weight regain

Cited by 32 publications

References 19 publications

Outcome of Sleeve Gastrectomy Converted to Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

Outcome of Sleeve Gastrectomy Converted to Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

Necrotizing Fasciitis and Barotrauma-Induced Pneumatocele Following Conversion of Gastric Bypass to Duodenal Switch: A Case Report

Interventions for Weight Regain after Bariatric Surgery

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