Two-stage laparoscopic biliopancreatic diversion with duodenal switch as treatment of high-risk super-obese patients: analysis of complications

Abstract

Complications after SG greatly decrease after the learning curve period and can be successfully managed without need of reoperation. Suture-line reinforcement, at least selectively in the middle-upper portion of the staple line and in super-super-obese patients, is recommended to decrease the incidence of specific complications.

Nonsurgical Treatment of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy

“…In the 100 consecutive cases in which routinely a running suture taking the complete stomach wall as staple line reinforcement was performed, leak presented in two cases. Oversewing successfully prevented staple line bleeding in all cases and diminished the incidence of leak formation but did not prevent it completely, confirming previous data published by us [19].…”

Clinical and Economic Evaluation of Absorbable Staple Line Buttressing in Sleeve Gastrectomy in High-Risk Patients

“…In some studies, authors considered the need of transfusion as hemorrhage [8,20,21], but the number of red cells unit needed to define hemorrhage can vary from 1 to 4. In other cases, authors considered only melena, hematemesis, or extra-luminal bleeding [22,23] as hemorrhage, regardless the need of transfusion. We considered as hemorrhagic the following complications: hematomas The positive effect of SLR in prevention of gastric bleeding in bariatric surgery has been observed not only for sleeve gastrectomy [1] but also for gastric bypass [24] from up to 10 years ago.…”

Laparoscopic Seromyotomy for Long Stenosis After Sleeve Gastrectomy with or Without Duodenal Switch

“…The more definitive procedure of DS or Roux-en-Y gastric bypass was deferred to allow an initial weight loss [10,11].…”