Revisional Malabsorptive Bariatric Surgery: 29-Year Follow-up in a Brazilian Public Hospital

Souto, Katia; Meinhardt, Nelson Guardiola; Dossin, Isabella de Azevedo; Ramos, Mauricio Jacques; Carnellos, Greyce; Mazzaferro, Cristina; Brasil, Paulo Renato Assis; Damin, Daniel C.

doi:10.1007/s11695-017-3023-9

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…Revisional bariatric operations are associated with higher complication rates than the initial procedures, regardless of the used technique, and according to the literature, rates vary from 13% to 55% in different studies 8 . Out of the 96 reviewed cases, 81 patients had successful outcomes, whereas 15 patients died, accounting for a mortality rate of 16.3%, which shows the complexity of a revisional operation for malnutrition.…”

Section: Discussionmentioning

confidence: 99%

“…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 - 27 .…”

Section: Discussionmentioning

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 - 27 .…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…Only one hospital in the capital of Paraná participated in the IFSO 2018 records 8 . Additionally, there are few Brazilian studies comparing the long-term impact of SG and RYGB techniques, mainly with regard to BMI reduction, weight loss, and gender influence 10 , 16 . Therefore, the expansion of national publications on the effects of BS, especially in the long term, has significant relevance for the follow-up and management of these patients.…”

Section: Introductionmentioning

confidence: 99%

Impact of Roux-en-Y Gastric Bypass and Vertical Gastrectomy on weight loss: a retrospective and longitudinal study in the State of Paraná, Brazil

GAMBA

Siqueira

TSUCHIYA

et al. 2023

Rev. Col. Bras. Cir.

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Aim: to compare the impact of Roux’s Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) techniques on body weight reduction over 1 and 5 years after bariatric surgery in obese patients in the state of Paraná. Methods: longitudinal and retrospective study, conducted between January 2010 and December 2013, with 737 patients of both sexes submitted to RYGB or SG and evaluated in the preoperative, 1 and 5 years after bariatric surgery (BS). Age, height, body weight, Body Mass Index (BMI), biochemical and pressure parameters were recorded. Results: of the total of patients, men represented lower frequency, were slightly older, with higher body weight, BMI and worse metabolic and pressure conditions than women in pre-BS (p<0.05). Regardless of sex, RYGB and SG were effective in promoting body weight reduction and BMI in 1 and 5 years after BS; the RYGB technique had greater impact on these variables in both sexes (p<0.05). The highest percentage of lost weight was observed in women who underwent the RYGB technique in the first year after BS. Five years after BS, the RYGB technique promoted a higher rate of body weight reduction in men and women compared to the SG technique (p<0.05). Conclusion: regardless of sex, the RYGB technique promotes a higher degree of body weight reduction and BMI over time compared to the SG; having its biggest impacts in the 1 year after BS, especially in women.

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“…Quality of life is compromised by flatulence, diarrhea, and foul odor in feces mainly due to steatorrhea caused by lower fat absorption. Such complications continue to occur even after more than 20 years of follow-up 4 , 12 , 35 in different moments of the postoperative period, which apparently are not predictable; these patients are reoperated for clinical complications or reviews for malnutrition or poor quality of life due to diarrhea and flatulence 28 .…”

Section: Introductionmentioning

confidence: 99%

Complications and Late Follow-Up of Scopinaro’s Surgery With Gastric Preservation: 1570 Patients Operated in 20 Years

Volpe¹,

Domene²,

Santana³

et al. 2022

ABCD, arq. bras. cir. dig.

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- BACKGROUND: Scopinaro-type biliopancreatic diversion (BPD-S) and its variations are the surgeries that offer the best immediate results in weight loss and regain in the late follow-up. It has a high rate of immediate complications and demands control with frequent laboratory tests. AIMS: The aim of this study was to analyze the late postoperative complications of 1570 patients operated by biliopancreatic diversion with gastric preservation laparoscopic video with up to 20 years of postoperative follow-up. METHODS: In a follow-up period of up to 20 years, the clinical and surgical complications of 1570 patients with grade II or III obesity were evaluated who were operated on from 2001 to 2014 with the same team of surgeons. Clavien Dindo 11 classification was used for analysis and comparison. Laboratory tests and body mass index (BMI) were used in the analysis of late metabolic outcomes. RESULTS: On the one hand, complications in 204 patients were recorded (13%), and 143 patients (9.1%) were reoperated. On the other hand, 61 patients (29.9%), who had postoperative complications were clinically treated with good evolution in 9.2 years (95%CI 8.2-10.3), with a median of 9.5 years (95%CI 6.1-12.9). Gastroileal anastomosis ulcers occurred in 44 patients (2.8%). Patients with malnutrition, severe anemia, or chronic diarrhea were operated on with common loop elongation (n=64 - 4%), conversion to gastric diversion (n=29 - 5%), or reversal of surgery (n=10 - 0.6%). One death was registered throughout casuistry (0.06%). CONCLUSIONS: Metabolic result of DBP-S was considered excellent in most patients, even referring to changes in the frequency of bowel movements, loose stools, and unpleasant odor. Complications are usually serious and most of the patients require surgical treatment. Therefore, the biliopancreatic diversion of Scopinaro should be reserved for exceptional cases, as there are safer surgical alternatives with less serious side effects.

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Revisional Malabsorptive Bariatric Surgery: 29-Year Follow-up in a Brazilian Public Hospital

Cited by 7 publications

References 18 publications

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

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

Impact of Roux-en-Y Gastric Bypass and Vertical Gastrectomy on weight loss: a retrospective and longitudinal study in the State of Paraná, Brazil

Complications and Late Follow-Up of Scopinaro’s Surgery With Gastric Preservation: 1570 Patients Operated in 20 Years

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