Digestive Adaptation with Intestinal Reserve: A Neuroendocrine-Based Operation for Morbid Obesity

Abstract

DAIR amplifies postprandial neuroendocrine response and provokes intense weight loss. DAIR reduces production of ghrelin and resistin and enables more nutrients to be absorbed distally enhancing GLP-1 and PYY secretion. Diabetes improved significantly without duodenal exclusion.

Revisional bariatric surgery: An update

“…Other strategies can include conversion to a classic duodenal switch operation (with Roux-en-Y configuration) or tosingle anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) to add malabsorption, with good results in primary cases in terms of additional weight loss and normalization of HbA1c levels in diabetic patients. [19,20] In 2002, Santoro et al developed a procedure combining sleeve gastrectomy with enterectomy thatretains the first 50 to 100 cm of jejunum and the last 200 to 250 cm of the ileum [21] and also reported good initial weight loss. An important goal with this type of interventions is to change neuroendocrine responses in bariatric patients, which is also targeted in sleeve gastrectomy with ileal transposition.…”

Tratamento cirúrgico da obesidade mórbida implicações gestacionais

“…Because of the broader knowledge that has been acquired about the role of enteropeptides produced by various segments of the digestive tract in response to the arrival of nutrients, this classification certainly tends to be replaced by the adaptive and enterohormonal role produced by several technical procedures in the metabolism and control of hunger and satiety. 13 In the 1950s, malabsorptive surgeries initiated the era of…”

Cirurgia gastrointestinal no tratamento da diabete tipo 2

“…Novos procedimentos cirúrgicos têm sido descritos com o objetivo de promover controle da diabete tipo 7,14,58 . Esses procedimentos utilizam os conhecimentos já adquiridos pelas cirurgias bariátricas tradicionais.…”

“…Santoro et al 58 publicaram artigo com 55 pacientes submetidos à gastrectomia vertical, omentectomia e ressecção de segmento de intestino delgado com remanescente de 300 cm (40 cm de jejuno e 260 cm de íleo) 58 . Na reconstrução intestinal realizaram anastomose jejunoileal a 80 cm da vál-vula ileocecal e uma gastroileostomia.…”