Laparoscopic Mini-gastric Bypass: Experience with Tailored Bypass Limb According to Body Weight

Lee, Wei Jei; Wang, Weu; Lee, Yi Chih; Huang, Ming Te; Ser, Kong Han; Chen, Jung-Chien

doi:10.1007/s11695-007-9367-9

Cited by 142 publications

(63 citation statements)

References 22 publications

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“…This “tailoring” has also been performed by other MGB/OAGB surgeons [22, 23, 34]. Although increased malabsorption could theoretically lead to more side effects and malnutrition, only 14 (1.1 %) patients suffered protein malnutrition.…”

Section: Discussionmentioning

confidence: 94%

Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients

Carbajo¹,

Luque-de-León²,

Jiménez³

et al. 2016

OBES SURG

306

157

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BackgroundExcellent results have been reported with mini-gastric bypass. We adopted and modified the one-anastomosis gastric bypass (OAGB) concept. Herein is our approach, results, and long-term follow-up (FU).MethodsInitial 1200 patients submitted to laparoscopic OAGB between 2002 and 2008 were analyzed after a 6–12-year FU. Mean age was 43 years (12–74) and body mass index (BMI) 46 kg/m2 (33–86). There were 697 (58 %) without previous or simultaneous abdominal operations, 273 (23 %) with previous, 203 (17 %) with simultaneous, and 27 (2 %) performed as revisions.ResultsMean operating time (min) was as follows: (a) primary procedure, 86 (45–180); (b) with other operations, 112 (95–230); and (c) revisions, 180 (130–240). Intraoperative complications led to 4 (0.3 %) conversions. Complications prompted operations in 16 (1.3 %) and were solved conservatively in 12 (1 %). Long-term complications occurred in 12 (1 %). There were 2 (0.16 %) deaths. Thirty-day and late readmission rates were 0.8 and 1 %. Cumulative FU was 87 and 70 % at 6 and 12 years. The highest mean percent excess weight loss was 88 % (at 2 years), then 77 and 70 %, 6 and 12 years postoperatively. Mean BMI (kg/m2) decreased from 46 to 26.6 and was 28.5 and 29.9 at those time frames. Remission or improvement of comorbidities was achieved in most patients. The quality of life index was satisfactory in all parameters from 6 months onwards.ConclusionsLaparoscopic OAGB is safe and effective. It reduces difficulty, operating time, and early and late complications of Roux-en-Y gastric bypass. Long-term weight loss, resolution of comorbidities, and degree of satisfaction are similar to results obtained with more aggressive and complex techniques. It is currently a robust and powerful alternative in bariatric surgery.

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Section: Discussionmentioning

confidence: 94%

Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients

Carbajo¹,

Luque-de-León²,

Jiménez³

et al. 2016

OBES SURG

306

157

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show abstract

“…An alternate and safer approach may be careful inspection of each case to assure not to leave a too-short common channel to the ileocecal valve, as there may be differences in the length of small bowel in different populations, to prevent severe malnutrition. Lee et al reported a tailored bypass limb approach according to BMI [12]. They incorporated different bypass limb lengths according to the patients’ BMI, which affects the excess weight loss percentage and presumably postoperative malnutrition rates.…”

Section: Discussionmentioning

confidence: 99%

Severe fatal protein malnutrition and liver failure in a morbidly obese patient after mini-gastric bypass surgery: Case report

Motamedi

Barzin

Ebrahimi

et al. 2017

International Journal of Surgery Case Reports

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“…Staple-line reinforcement was not performed unless clinically indicated. The length of small bowel bypassed distal to Treitz' ligament was selected according to the BMI and amount of excess weight [33]; most common length was 180 cm. The anastomosis was then performed side-to-side with an endo-GIA.…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic mini-gastric bypass in patients age 60 and older

Peraglie

2015

Surg Endosc

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Laparoscopic Mini-gastric Bypass: Experience with Tailored Bypass Limb According to Body Weight

Abstract: Morbidly obese patients receiving gastric bypass surgery may need to tailor the bypass limb according to BMI. The application of gastric bypass in lower BMI patients should be more carefully.

Cited by 142 publications

References 22 publications

Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients

Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients

Severe fatal protein malnutrition and liver failure in a morbidly obese patient after mini-gastric bypass surgery: Case report

Laparoscopic mini-gastric bypass in patients age 60 and older

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