Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel

Merz, Alexa; Blackstone, Robin P.; Gautier, Michel; Torres, Antonio; Himpens, Jacques; Higa, Kelvin; Rosenthal, Raúl J.; Lloyd, Aaron; DeMaria, Eric J.

doi:10.1016/j.soard.2019.03.009

Cited by 39 publications

(24 citation statements)

References 27 publications

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“…Only 3.9% of surgeons would perform BPD/DS as second stage procedure for patients BMI greater than 50 kg/m 2 . Safety and efficacy of conversional surgeries have been confirmed by several studies [26,27,32,35,58,[61][62][63]. Moreover, as reported in previous published studies [27,32,35,61,63], there was a wide time interval between the two stages.…”

Section: Discussionmentioning

confidence: 59%

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The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

et al. 2022

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Background Bariatric surgery in patients with BMI over 50 kg/m2 is a challenging task. The aim of this study was to address main issues regarding perioperative management of these patients by using a worldwide survey. Methods An online 48-item questionnaire-based survey on perioperative management of patients with a BMI superior to 50 kg/m2 was ideated by 15 bariatric surgeons from 9 different countries. The questionnaire was emailed to all members of the International Federation of Surgery for Obesity (IFSO). Responses were collected and analyzed by the authors. Results 789 bariatric surgeons from 73 countries participated in the survey. Most surgeons (89.9%) believed that metabolic/bariatric surgery (MBS) on patients with BMI over 50 kg/m2 should only be performed by expert bariatric surgeons. Half of the participants (55.3%) believed that weight loss must be encouraged before surgery and 42.6% of surgeons recommended an excess weight loss of at least 10%. However, only 3.6% of surgeons recommended the insertion of an Intragastric Balloon as bridge therapy before surgery. Sleeve Gastrectomy (SG) was considered the best choice for patients younger than 18 or older than 65 years old. SG and One Anastomosis Gastric Bypass were the most common procedures for individuals between 18 and 65 years. Half of the surgeons believed that a 2-stage approach should be offered to patients with BMI > 50 kg/m2, with SG being the first step. Postoperative thromboprophylaxis was recommended for 2 and 4 weeks by 37.8% and 37.7% of participants, respectively. Conclusion This survey demonstrated worldwide variations in bariatric surgery practice regarding patients with a BMI superior to 50 kg/m2. Careful analysis of these results is useful for identifying several areas for future research and consensus building.

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Section: Discussionmentioning

confidence: 59%

“…The BPD/DS maybe the most effective bariatric procedure for patients with BMIs over 50 kg/m 2 as primary procedure [56,57] or as conversion after primary SG [58]. However, it may have higher rates of malnutrition, diarrhea and fecal incontinence [59].…”

Section: Discussionmentioning

confidence: 99%

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

et al. 2022

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“…Statistics in recent years have shown that the proportion of BPD/DS procedures among all bariatric and metabolic surgeries is gradually decreasing. At present, BPD/DS and related procedures are more often used in superobese (BMI ≥ 50 kg/m 2 ) patients or in those with inadequate weight loss after SG in the absence of reflux symptoms, with maximal %EWL ranging from 70% to 80% at two years [24] …”

Section: Bariatric Surgerymentioning

confidence: 99%

From surgery to endoscopy: the evolution of the bariatric discipline

Wei

Zhang

2022

Chinese Medical Journal

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Obesity, with its increasing morbidity and prevalence, is now a worldwide public health problem. Obesity and its related comorbidities impose a heavy burden on societal health and the economy. The practice of bariatric surgery has evolved from its early surgical procedures, many of which are no longer routine operations. With clinical practice, research, and experience, bariatric surgery has gradually become an important last resort for the control of weight and obesity-related metabolic diseases in moderately and severely obese patients. However, there is still room for further improvements in bariatric surgical procedures, especially with regard to long-term issues and complications. Endoscopic weight loss technology has developed rapidly in recent years. The advantages of this technology include minimal invasiveness, an obvious weight loss effect, and few complications, thus filling the gap between medications and lifestyle adjustments and surgical treatment of obesity. Endoscopic weight loss technology may even replace surgical bariatric procedures. This review summarized the current status of bariatric metabolic surgery and newly developed bariatric endoscopic procedures.

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“…As a trial reports, 23 of 80 GERD patients receiving RYGB maintained reflux after 6 months, especially in patients with previous gastric banding. 104 With more postoperative complications, LTC should be avoided in LSG patients with GERD, BPD/DS, 105 , 106 and One-anastomosis gastric bypass (OAGB). 107 Manabu Amiki had the same conclusion, that is, LBPD/DS or duodenojejunal bypass (DJB) as revision surgery appears to be effective for further weight loss in the medium term, and laparoscopic RYGB appears to be effective for GERD remission.…”

Section: Revisional Surgeries For Complications Of Lsgmentioning

confidence: 99%

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Li¹,

Jiao²,

Zhang³

et al. 2021

DMSO

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Bariatric surgery has become increasingly common due to the worldwide obesity epidemic. A shift from open to laparoscopic surgery, specifically, laparoscopic sleeve gastrectomy (LSG), has occurred in the last two decades because of the low morbidity and mortality rates of LSG. Although LSG is a promising treatment option for patients with morbid obesity due to restrictive and endocrine mechanisms, it requires modifications for a subset of patients because of weight regain and tough complications, such as gastroesophageal reflux, strictures, gastric leak, and persistent metabolic syndrome., Revision surgeries have become more and more indispensable in bariatric surgery, accounting for 7.4% in 2016. Mainstream revisional bariatric surgeries after LSG include Roux-en-Y gastric bypass, repeated sleeve gastrectomy, biliopancreatic diversion, duodenal switch, duodenal-jejunal bypass, one-anastomosis gastric bypass, single anastomosis duodeno-ileal bypass (SAID) and transit bipartition. This review mainly describes the revisional surgeries of LSG, including the indication, choice of surgical method, and subsequent effect.

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Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel

Abstract: Duodenal switch in revisional bariatric surgery. Duodenal switch in revisional bariatric surgery: conclusions from an expert consensus panel.

Cited by 39 publications

References 27 publications

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

From surgery to endoscopy: the evolution of the bariatric discipline

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

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