Is transit bipartition a better alternative to biliopancreatic diversion with duodenal switch for superobesity? Comparison of the early results of both procedures

Topart, Philippe; Bécouarn, Guillaume; Finel, Jean-Baptiste

doi:10.1016/j.soard.2019.12.019

Cited by 25 publications

(14 citation statements)

References 21 publications

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“…Several bariatric procedures have been proposed to treat severe obesity with BMI > 50 kg/m 2 , including Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), single anastomosis duodeno-ileal bypass (SADI), sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch (BPD-DS) [8][9][10][11][12][13][14][15]. There is still no robust evidence supporting the choice of one procedure over the others.…”

Section: Introductionmentioning

confidence: 99%

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

et al. 2021

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Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 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, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract

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Section: Introductionmentioning

confidence: 99%

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

et al. 2021

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“…However, they also resulted in unwanted effects, such as excessive nutrient malabsorption (58). In contrast, several metabolic procedures (such as SG-JJB, SG-II, SG-TB, and SG) that maintain the foregut (either completely or partially) have been demonstrated to have efficacy that is not inferior to foregut exclusion procedures (6)(7)(8)(9)(10)(11)(12)(13). It is imperative to acknowledge that the SG procedure has been the most performed bariatric procedure worldwide in recent years, surpassing RYGB (31).…”

Section: Discussionmentioning

confidence: 99%

“…While the hindgut theory (rapid transit of nutrients to the distal intestine) has been widely accepted, the foregut theory is not (4,5). Several procedures that do not comprise duodenal exclusions, such as sleeve with jejunojejunal bypass/SG-JJB, sleeve with ileal interposition/SG-II, sleeve with transit bipartition/SG-TB, and standalone sleeve gastrectomy/SG (Figure 1), have similar diabetes remission outcomes when compared with procedures comprising duodenal exclusions, such as gastric bypass/GB, biliopancreatic diversion with duodenal switch/DS, and diverted sleeve with ileal interposition/DSG-II (Figure 2) (6)(7)(8)(9)(10)(11)(12)(13). Furthermore, the complete exclusion of the proximal intestine may result in significant micronutrient malabsorption.…”

Section: Introductionmentioning

confidence: 99%

Can we abandon foregut exclusion for an ideal and safe metabolic surgery?

et al. 2022

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Foregut (foregut exclusions) and hindgut (rapid transit of nutrients to the distal intestine) theories are the most commonly used explanations for the metabolic improvements observed after metabolic surgeries. However, several procedures that do not comprise duodenal exclusions, such as sleeve with jejunojejunal bypass, ileal interposition, and transit bipartition and sleeve gastrectomy were found to have similar diabetes remission rates when compared with duodenal exclusion procedures, such as gastric bypass, biliopancreatic diversion with duodenal switch, and diverted sleeve with ileal interposition. Moreover, the complete exclusion of the proximal intestine could result in the malabsorption of several important micronutrients. This article reviews commonly performed procedures, with and without foregut exclusion, to better comprehend whether there is a critical need to include foregut exclusion in metabolic surgery.

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“…In einer weiteren Studie konnte die TB bei Patienten mit einem BMI > 50 kg/m 2 im Vergleich zum BPD-DS zwar nicht die gleiche Gewichtsreduktion erreichen, jedoch zeigte sich in Bezug auf Komplikationsrate und Nebenwirkungen wie Frequenz der Stuhlentleerungen, Fettstühle und Malnutrition, insbesondere Proteinmangel, ein deutlicher Vorteil für die TB. Zumindest bis zum 1-Jahres-Follow-up waren die Rückbildungsraten der Komorbiditäten sehr gut und vergleichbar zwischen beiden Verfahren [20]. Weiterhin liegen nun erste Daten vor, die zeigen, dass diese OP-Verfahren in einem Stufenkonzept als Revisionseingriffe nach Sleeve-Gastrektomie ebenso gut geeignet sind [21].…”

Section: Cme-fortbildungunclassified

Der Stellenwert neuerer Verfahren in der Adipositaschirurgie (SADI, SASI und Co.)

Gärtner¹,

Schöttler²,

Popp³

2022

Allgemein- und Viszeralchirurgie up2date

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Die Adipositaschirurgie bietet die effektivste Therapieoption für die Adipositas und ihre Nebenerkrankungen. Von Beginn an unterlag diese Chirurgie einem steten Wandel. Durch Modifikationen etablierter OP-Methoden wollen die neueren Verfahren die Invasivität und die unerwünschten Wirkungen reduzieren. Der folgende Beitrag zeigt, inwieweit dies gelingt und welche Verfahren das Potenzial zum Standardverfahren haben.

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Is transit bipartition a better alternative to biliopancreatic diversion with duodenal switch for superobesity? Comparison of the early results of both procedures

Cited by 25 publications

References 21 publications

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

Can we abandon foregut exclusion for an ideal and safe metabolic surgery?

Der Stellenwert neuerer Verfahren in der Adipositaschirurgie (SADI, SASI und Co.)

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