Improvement of Weight Loss and Metabolic Effects of Vertical Banded Gastroplasty by an Added Duodenal Switch Procedure and Metabolic Effects

Yashkov, Yury I.; Oppel, Tatiana A; Шишло, Л. А.; Vinnitsky, L. I.

doi:10.1381/09608920160556878

Cited by 20 publications

(9 citation statements)

References 18 publications

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“…Also, Gabriel et al [13] performed a LAGB with a BPD and reported as much as 99.6% reduction in excess weight at 2 years. Combining previous gastric restrictive surgery with a subsequent BPD has also been previously described [14,15].These procedures are more invasive than this technique but represent other means for a combined restrictive/malabsorptive procedure.…”

Section: Discussionmentioning

confidence: 97%

Laparoscopic Adjustable Banded Sleeve Gastrectomy as a Primary Procedure for the Super-Super Obese (Body Mass Index > 60 kg/m2)

et al. 2010

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Isolated laparoscopic sleeve gastrectomy is increasingly being used for the treatment of morbid obesity. However, doubts still persist regarding long-term weight loss, and the 5-year results are awaited. Whether the aetiology of failed excess weight loss is the result of an inadequate sleeve or attributable to dilatation of the sleeve is not clear. In an effort to prevent gastric dilatation and increase gastric restriction to promote further weight loss in the long term, we performed a combined procedure of laparoscopic adjustable gastric banding with sleeve gastrectomy. The patient was a 39-year-old woman with a life-long history of obesity and a body mass index of 79.8 kg/m(2). The surgical technique of the laparoscopic adjustable gastric banded sleeve gastrectomy is described. There were no immediate complications, and the patient was discharged home on the third postoperative day. She is doing extremely well on clinic follow-up at 6 weeks. To the best of our knowledge, laparoscopic adjustable gastric banded sleeve gastrectomy, as a primary operation, has not been described in the literature. It is hoped that this combined procedure will be most useful in the super-super obese (body mass index > 60) patients. More patients with a long-term follow-up are necessary to provide definitive conclusions regarding long-term benefits and complications of this combined bariatric procedure.

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Section: Discussionmentioning

confidence: 97%

Laparoscopic Adjustable Banded Sleeve Gastrectomy as a Primary Procedure for the Super-Super Obese (Body Mass Index > 60 kg/m2)

et al. 2010

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“…Up to 75% of patients ended with a BMI less than 35 kg/m 2 (good) [19]. DS is another interesting option in this patient population, but larger series are still needed [7,10,12,16,18,30]. Because of the superior weight loss seen with the DS when compared to other bariatric procedures, interest has grown in using this procedure in the treatment of morbidly obese patients who fail in other surgical therapy [16,18,23].…”

Section: Discussionmentioning

confidence: 99%

“…The DS was first used as a revisional therapy in 2001 to treat a patient who had undergone VBG in the past, and was still suffering from diabetes mellitus and obesity. At one-year follow-up, after open DS, the patient's diabetes had resolved [7]. The use of DS as a revisional therapy has become even more widespread since it was carried out laparoscopically [2].…”

Section: Discussionmentioning

confidence: 99%

Gastric banding: Conversion to sleeve, bypass, or DS

Gautier

Gumbs

2007

Surg Endosc

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A review of conversions of gastric banding for obesity to Roux-en-Y gastric bypass, gastric sleeve, or duodenal switch attempts to determine which revisional procedure best enhances weight loss. Indications for these conversions are multiple and include hardware problems, motility problems, and miscellaneous like inadequate weight loss. Analysis of band conversions to band of 193 patients, and bands to gastric bypass in 214 patients reveals better weight loss with the latter strategy. Smaller cohorts of patients who underwent a biliopancreatic diversion or simply a sleeve gastrectomy are too small to conclude on their efficacy. Prospective randomized trials are needed to determine which revisional procedure is best in the setting of inadequate weight loss of excessive weight regain after gastric adjustable banding for severe obesity.

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“…15-~7 DS is also an acceptable option in patients with inadequate weight loss, but larger series are needed to confirm this. 45 With AGB, reoperation is a good option in patients who have hardware problems from their bands, particularly port-site complications. 22 Nonetheless, in the setting of inadequate weight loss after band placement, RYGBP appears to be a superior procedure.…”

Section: Revision For Inadequate Weight Lossmentioning

confidence: 99%

Revisional bariatric surgery for inadequate weight loss

2007

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When behavioral or anatomic issues are not present, revisional surgery should be approached with a goal of treating malnutrition or enhancing excess weight loss. Unfortunately, no randomized controlled trials currently exist to help the practicing bariatric surgeon choose which revisional procedure to perform. A review of the available literature was undertaken and compared with our standard practices to see if any guidelines could be devised. At our institution, patients who have failed jejunal-ileal bypass are reversed in the setting of malnutrition and converted to a sleeve gastrectomy (SG) followed by duodenal switch (DS) as a second stage procedure in the setting of inadequate weight loss. After failed vertical banded gastroplasty (VBG), patients are converted to a Roux-en-Y gastric bypass (RYGBP). After failed adjustable gastric band (AGB) placement, we perform RYGBP. In the super-obese, we leave the band in place or convert to a DS with band removal. In patients with failed RYGBP, we convert our patients to DS, but placement of an AGB may be an acceptable option.

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Improvement of Weight Loss and Metabolic Effects of Vertical Banded Gastroplasty by an Added Duodenal Switch Procedure and Metabolic Effects

Abstract: DS per se in the case presented had a decisive effect on DM2 and hypercholesterolemia. DS should be kept in mind as a second-step malabsorptive procedure after a failed purely restrictive operation.

Cited by 20 publications

References 18 publications

Laparoscopic Adjustable Banded Sleeve Gastrectomy as a Primary Procedure for the Super-Super Obese (Body Mass Index > 60 kg/m2)

Laparoscopic Adjustable Banded Sleeve Gastrectomy as a Primary Procedure for the Super-Super Obese (Body Mass Index > 60 kg/m2)

Gastric banding: Conversion to sleeve, bypass, or DS

Revisional bariatric surgery for inadequate weight loss

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