Short or Long Biliopancreatic Limb Bypass as a Secondary Procedure After Failed Laparoscopic Sleeve Gastrectomy

Kraljević, Marko; Süsstrunk, Julian; Köstler, Thomas; Lazaridis, Ioannis; Zingg, Urs; Delko, Tarik

doi:10.1007/s11695-020-04868-8

Cited by 16 publications

(15 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of course, the amount of additional weight loss after a conversion from SG to another procedure not only depends on the procedure itself but majorly on the way it is done. Kraljevic M. et al compared different biliopancreatic limb lengths in RYGB and OAGB as revisional procedures and found that a longer biliopancreatic limb should be considered in patients with weight regain and insufficient weight loss after SG [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

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

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Furthermore, in anastomotic leaks, the spillage of intestinal fluid and bile is frequently responsible for generalized peritonitis, due to the location of the anastomosis. The length of the common limb is another debated technical topic and is of maximal importance for its relationship with both the efficacy of weight loss and the rate of nutritional complications [34][35][36][37][44][45][46]. In the present series, three patients have been treated for severe malnutrition (two with medical treatment, one with surgical revision).…”

Section: Discussionmentioning

confidence: 95%

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

View full text Add to dashboard Cite

Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

show abstract

“…Besides, in failed laparoscopic sleeve gastrectomy cases, revisional surgery with long BPL procedures (RYGB or OAGB) ensued a significant long-term weight loss at three years [ 21 ]. A similar benefit was reported in revisional surgery after failed RYGB.…”

Section: Discussionmentioning

confidence: 99%

“…It may lead to superior stimulation of the distal intestine and altered bile acids and intestinal microbiota [ 18 ]. Also, available evidence indicates that long BPL in biliopancreatic diversion can be a key factor in explaining this procedure’s superiority in achieving weight loss [ 21 ]. A longer BPL bypassed more of the jejunum, leading to early malabsorption of nutrients, causing a significant early loss of weight.…”

Section: Discussionmentioning

confidence: 99%

One Anastomosis Gastric Bypass Versus Long Biliopancreatic Limb Roux-en-Y Gastric Bypass

et al. 2022

View full text Add to dashboard Cite

Background Roux-en-Y gastric bypass (RYGB) is one of the most effective bariatric procedures. The study aimed to explore the value of lengthening the biliopancreatic limb (BPL) in RYGB compared to the outcome of one-anastomosis gastric bypass (OAGB). Methods This prospective study included morbidly obese patients divided into two groups. The RYGB group (n = 36) was subjected to long biliary limb Roux-en-Y gastric bypass (LPRYGB), and the OAGB Group (n = 36) had one anastomosis gastric bypass. During follow-up, weight, BMI, percentage of excess body weight loss (%EBWL), resolution of obesity-related comorbidities, and quality of life (QoL) were evaluated. Results There was no significant difference in weight and BMI after 3 and 6 months. At 12-month follow-up, weight loss was significantly higher in the OAGB group. After 12 months, the two groups showed significant improvement of comorbid conditions without significant difference between the two groups. The Qol was significantly higher in the LPRYGB group 3, 6, and 12 months after surgery compared to the OAGB group. Conclusions Extending the BPL length in RYGB to 150 cm is as effective as OAGB in remission of comorbidities, including diabetes. It was also equally effective in weight reduction in the short term. OAGB was more efficient in weight reduction and a significantly faster operation. LPRYGB showed a better QoL of life 1 year after surgery. Graphical abstract

show abstract

Short or Long Biliopancreatic Limb Bypass as a Secondary Procedure After Failed Laparoscopic Sleeve Gastrectomy

Cited by 16 publications

References 35 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

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

One Anastomosis Gastric Bypass Versus Long Biliopancreatic Limb Roux-en-Y Gastric Bypass

Contact Info

Product

Resources

About