Long Alimentary Limb Duodenal Switch (LADS): an Exploratory Randomized Trial, Results at 2 Years

Malo, François-Charles; Marion, Andréanne; Rioux, Antoine; Lebel, Stéfane; Hould, Frédéric‐Simon; Julien, F. H.; Marceau, Simon; Lescelleur, Odette; Lafortune, Annie; Bouvet-Bouchard, Léonie; Biertho, Laurent

doi:10.1007/s11695-020-04968-5

Cited by 6 publications

(1 citation statement)

References 19 publications

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“…Lupoli et al 34 proposed that abnormality of bone metabolism after bariatric surgery could be attributed to diminished mechanical loading, calcium/vitamin D malabsorption with secondary hyperparathyroidism, nutritional deprivations, changes in fat mass, and alterations in fat-and gut-derived hormones. To assess the effect of limb lengths on nutrition outcomes after BPD-DS, Malo et al 35 conducted a study by comparing the long alimentary limb (±600 cm) and a standard (250 cm) BPD-DS with the fixed common channel (100 cm). While there was no significant clinical effect on nutrition outcomes based on the length of the alimentary limb, the long alimentary limb cohort had higher mean calcium and vitamin D levels at 24 months.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Long-Term Nutrition Outcomes After Duodenal Switch: A Systematic Review and Meta-Analysis

Nakanishi,

Abi Mosleh,

AL-Kordi

et al. 2023

The American Surgeon™

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Background Biliopancreatic diversion with duodenal switch (BPD-DS) is the most effective and durable metabolic and bariatric surgery to achieve a target weight loss. However, many surgeons are hesitant to adopt BPD-DS due to a lack of training, technical complexity, and long-term nutrition deficiencies. This meta-analysis aimed to investigate long-term nutrition outcomes after primary BPD-DS in the management of obesity. Methods Cochrane, Embase, PubMed, Scopus, and Web of Science were searched for articles from their inception to February 2023 by 2 independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42023391316). Results From 834 studies screened, 8 studies met the eligibility criteria, with a total of 3443 patients with obesity undergoing primary BPD-DS. At long-term follow-up (≥5 years), 25.4% of patients had vitamin A deficiency (95% CI: -.012, .520, I2 = 94%), and 57.3% had vitamin D deficiency (95% CI: .059, 1.086, I2 = 86%). Calcium deficiency was observed in 125 patients (22.2%, 95% CI: .061, .383, I2 = 97%), and 69.7% had an abnormal parathyroid hormone level (95% CI: .548, .847, I2 = 78%). Ferritin level was abnormal in 30 patients (29.0%, 95% CI: .099, .481, I2 = 79%). Conclusions Despite displaying comparable nutrition-related outcomes to mid-term follow-up, our study demonstrated that BPD-DS could result in a high level of long-term nutrition deficiency after BPD-DS for selected patients. However, further randomized controlled studies with standardized supplementation regimens and improvement in compliance are necessary to evaluate and prevent long-term nutritional deficiencies after BPD-DS.

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Section: Discussionmentioning

confidence: 99%