Management of Excessive Weight Loss Following Laparoscopic Roux-en-Y Gastric Bypass: Clinical Algorithm and Surgical Techniques

Akusoba, Ikemefuna; Birriel, T. Javier; Chaar, Maher El

doi:10.1007/s11695-015-1775-7

Cited by 17 publications

(8 citation statements)

References 34 publications

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“…RYGB is a bypass operation in which a small gastric pouch is formed and most of the digestive stomach is excluded. Thus, the food goes from the esophagus directly into the formed small gastric pouch, and then is drained into the small intestine, ie, bypassing the duodenum, gets directly into the distal small intestine [78]. Gastric bypass surgery provides significant weight loss with minimum complications [79].…”

Section: Resultsmentioning

confidence: 99%

The role of bariatric surgery and appetite-related hormones metabolism in obesity treatment: a literature review

Nykonenko

Haidarzhi

Nykonenko

et al. 2018

ZMJ

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Section: Resultsmentioning

confidence: 99%

The role of bariatric surgery and appetite-related hormones metabolism in obesity treatment: a literature review

Nykonenko

Haidarzhi

Nykonenko

et al. 2018

ZMJ

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“…With regard to the clinical presentation, patients with severe malnutrition requiring revisional operations, usually have hypoalbuminemia, anemia, renal failure, liver failure, ascites, anasarca, and they require preoperative parenteral nutrition 8,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Nr -Not Reported -Bmi: Body Mass Index; Bpd -Biliopancreatic Diversion; Bpd-ds -Biliopancreatic Diversion With Duodenal Switch; mentioning

confidence: 99%

“…Revision procedures (elongation of the common channel) and conversion techniques are mostly associated with malabsorption, such as BPD, BPD with duodenal switch, and distal gastric bypass, into conventional gastric bypass are widely used techniques and they also maintain a metabolic component to prevent obesity relapse. Reversals are obviously chosen in patients with severe malnutrition or those who underwent revisional surgery 8,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Nr -Not Reported -Bmi: Body Mass Index; Bpd -Biliopancreatic Diversion; Bpd-ds -Biliopancreatic Diversion With Duodenal Switch; mentioning

confidence: 99%

“…Several options can be considered, including proximal side-to-side anastomosis between the alimentary and biliopancreatic limbs or the alimentary limb that can be sectioned above the interstitial anastomosis as close as possible to the angle of Treitz 10 . Akusoba et al 27 proposed an algorithm for managing patients with excessive weight loss. A gastrostomy must be performed in the excluded stomach for patients without strictures in the gastrointestinal tract, without psychiatric disorders, and with good caloric intake.…”

Section: Nr -Not Reported -Bmi: Body Mass Index; Bpd -Biliopancreatic Diversion; Bpd-ds -Biliopancreatic Diversion With Duodenal Switch; mentioning

confidence: 99%

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Revisional surgery in severe nutritional complications after bariatric surgical procedures: report of four cases from a single institution and review of the literature

Braga

Concon

Lima

et al. 2021

Rev. Col. Bras. Cir.

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Introduction: bariatric surgery is currently the only treatment that leads to long-term and sustained weight loss and decreased morbidity and mortality in morbidly obese individuals. Roux-en-Y bypass causes weight loss by restricting food intake associated with reduced intestinal absorption, in addition to multiple endocrine and satiogenic effects. Biliopancreatic diversion promotes weight loss mainly due to poor absorption of the nutrients ingested. Both procedures exclude parts of the gastrointestinal tract. Objective: to describe four cases of revisional surgery after primary bariatric surgery, due to serious nutritional complications, and to review the literature regarding this subject. Methods: a retrospective analysis of patients of Unicamps bariatric center database and review of the literatures were performed. Results: four patients were identified, 2 women and 2 men, with a mean age of 48 years. The mean body mass index before revisional surgery was 23.7 kg/m2. Three patients underwent Scopinaro biliopancreatic diversion, and onde patient underwent Roux-en-Y gastric bypass. The revisional surgeries were revision, conversion, and reversion. One patient died. For the review of the literature 12 articles remained (11 case reports and 1 case series). Another five important original articles were included. Conclusion: fortunately, revision surgery is rarely necessary, but when indicated it has increased morbidity, It can be revision, reverion or conversion according to the severity of the patient and the primary surgery performed.

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“…So that the younger, lower BMI, lower body fat percentage and android fat distribution phenotype of bariatric candidates probably have more successful weight loss and also, they are more vulnerable to have EXWL [5][6][7][8]. Most of the studies in subject of EXWL are in the case reports level of evidences, all over the world [9][10][11]. So, there is not an accurate statistics respect of prevalence or probability of EXWL after bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Estimation Of Excessive Weight Loss In Bariatric Surgery Patients: A Prediction Model Retrospective Cohort Study

Hatami

Pazouki

Kabir

2021

Preprint

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Background and Objective: Bariatric surgery has been recognized as the most effective long-term treatment for morbid obesity. Despite the considerable positive results, adverse consequence can develop. Excessive Weight Loss (EXWL), a rare consequence of bariatric surgery, can lead to a broad adverse consequence. The aim of this study was determining of prevalence and the predicting model of EXWL in patient underwent bariatric surgery until 24 months after surgery.Material and Methods: Data have been extracted from the National Obesity Surgery Database in obesity clinic of * University of Medical Sciences. The subjects of this retrospective cohort study were morbid obese individuals who underwent three various types of bariatric surgery (One Anastomosis Gastric Bypass (OAGB), Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG)) in period of 24 months ago. EXWL has been defined as excess weight loss more than 100% at any time until 24 months after surgery. SPSS (version 23) was used in data analysis.Results: Among 4214 subjects of this study, most excess weight loss after surgery has taken place in 18 months after surgery. 18.5% (n=407) of patients experienced EXWL with highest percentage among OAGB patients (22.6%). The females (20.4% vs.9.9%) and younger persons (35.45 ± 10.25 vs. 39.06 ± 10.76) were more susceptible to EXWL. patients with EXWL had significantly lower BMI (body mass index) (41.11± 4.51 vs. 46.73±6.26) (Kg/m2), and were less probable to had emotional eating. Visceral fat level, fat percentage and BMI were the best predictor of EXWL (P-value for all <0.05).Conclusions: Surgery should be adjusted in younger females with a lower BMI and healthy metabolic status who are more prone to EXWL. In such a way that minimize weight loss speed/value. It may be possible by selection of other surgery procedures, rather than OAGB, tighter follow ups and consultations of patients after surgery is emphasized for more EXWL vulnerable patients.

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Management of Excessive Weight Loss Following Laparoscopic Roux-en-Y Gastric Bypass: Clinical Algorithm and Surgical Techniques

Abstract: We propose a practical clinical algorithm for the work-up and management of patients with excessive weight loss and protein calorie malnutrition after standard RYGB including reversal to normal anatomy.

Cited by 17 publications

References 34 publications

The role of bariatric surgery and appetite-related hormones metabolism in obesity treatment: a literature review

The role of bariatric surgery and appetite-related hormones metabolism in obesity treatment: a literature review

Revisional surgery in severe nutritional complications after bariatric surgical procedures: report of four cases from a single institution and review of the literature

Estimation Of Excessive Weight Loss In Bariatric Surgery Patients: A Prediction Model Retrospective Cohort Study

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