Laparoscopic Biliopancreatic Diversion with Duodenal Switch - The Most Effective Operation for Type 2 Diabetes Mellitus. How I do it?

Copăescu, C

doi:10.21614/chirurgia.113.5.704

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…19 BPD-DS is the most effective surgery in terms of the durability of weight loss and diabetes remission. 20 Preservation of the pylorus and the first part of the duodenum can address calcium and iron deficiencies to some extent but extensive intestinal bypass leaving only 1 m for absorption, increases the risk of severe protein-energy malnutrition, severe nutritional deficiencies, and renal stones. 21 To reduce malabsorption and simplify the BPD-DS procedure, Sánchez-Pernaute et al proposed a loop modification of the duodenal switch in 2007, by anastomosing the duodenum directly to a loop of ileum 2 m proximal to the ileocecal junction.…”

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of Laparoscopic Sleeve Gastrectomy with Loop Duodenal Switch Surgery for Obesity in Indian Patients

Vennapusa¹,

Panchangam²,

Kesara³

et al. 2020

World Journal of Laparoscopic Surgery With DVD

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Aim: Laparoscopic sleeve gastrectomy with loop duodenal switch (SLDS) surgery is a loop modification of biliopancreatic diversion with duodenal switch (BPD-DS) aimed at reducing malabsorption without compromising on the efficacy. This study aimed to analyze the safety and feasibility of SLDS surgery in Indians suffering from obesity. Materials and methods: This was a retrospective study analyzing 169 patients who underwent SLDS surgery between November 2013 and June 2020. The cohort was divided into two subgroups based on the common channel length-2.5 and ≥3 m. Weight-loss parameters, diabetes remission, and investigations at 6 months and 1 year follow-up were analyzed in the total cohort and common channel subgroups. The percentage of total weight loss (%TWL) ≥25% was considered as a successful weight-loss outcome. HbA1C <6% without the need for antidiabetic medications was considered as complete diabetes remission. Safety was analyzed in terms of intraoperative and postoperative complications. Results: Mean preoperative body mass index was 45.39 ± 7.6 kg/m 2 . 48.52% of the patients were suffering from type II diabetes. Mean %TWL was 30.91 ± 4.98 and 41.86 ± 7.63% and complete diabetes remission was 81.82 and 89.06% at 6 months and 1 year follow-up, respectively. The percentage of total weight loss was inversely proportional to the common channel length. Complete diabetes remission was not significantly affected by the common channel length. Serum albumin <3 gm/dL was significantly high in patients with a common channel length of 2.5 vs ≥3 m-25 vs 4.65% at 6 months and 40 vs 7.14% at 1 year follow-up, respectively. Thirty-day mortality was zero. Conclusion: Sleeve gastrectomy with loop duodenal switch surgery appears to be effective and safe in Indian patients. Malabsorption risk is greatly reduced when the common channel length is ≥3 m. Clinical significance: Sleeve gastrectomy with loop duodenal switch surgery with the common channel length ≥3 m simplifies BPD-DS, gives excellent weight loss and diabetes remission with minimal malabsorption. Restricting the biliopancreatic limb to ≤55% prevents adverse malabsorptive consequences.

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Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of Laparoscopic Sleeve Gastrectomy with Loop Duodenal Switch Surgery for Obesity in Indian Patients

Vennapusa¹,

Panchangam²,

Kesara³

et al. 2020

World Journal of Laparoscopic Surgery With DVD

View full text Add to dashboard Cite

show abstract

“…Laparoscopic biliopancreatic diversion with duodenal switch (BPD DS) is the most effective bariatric surgery for long-term weight loss and remission from diabetes. 4 However, risk of severe malabsorption is very high in BPD DS since a significant length of the small intestine is bypassed. 5 The gold standard bariatric surgery, laparoscopic Roux-en-Y gastric bypass (RYGB), is associated with complications such as at-risk gastric remnant, marginal ulcers, internal hernias, and dumping syndrome.…”

Section: Introductionmentioning

confidence: 99%

Factors Predicting Weight Loss after “Sleeve Gastrectomy with Loop Duodenojejunal Bypass” Surgery for Obesity

Vennapusa

Panchangam²,

Kesara

et al. 2020

Journal of Obesity & Metabolic Syndrome

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Background Laparoscopic sleeve gastrectomy with loop duodenojejunal bypass (SG LDJB) is a loop modification of biliopancreatic diversion with duodenal switch. The aim of this study was to analyze weight loss response and factors predicting weight loss outcomes after SG LDJB. Methods This was a retrospective study analyzing SG LDJB surgeries performed between May 2013 and December 2017 in 126 Indians suffering from obesity. The collected data was analyzed to understand weight loss efficacy and the factors predicting weight loss. Surgery was considered successful when percentage excess weight loss (%EWL) was ≥50% or percentage total weight loss (%TWL) was ≥25%. Results %EWL was 95.77% and 83.84% and %TWL was 34.64% and 30.32% at the 1-year and 3-year follow-up, respectively. %EWL ≥50% was 99.04% and 96.47% and %TWL ≥25% was 91.35% and 75.29% at the 1-year and 3-year follow-up, respectively. Patient age and sex did not independently predict %EWL or %TWL. Preoperative body mass index (BMI), weight, and excess weight negatively predicted %EWL and positively predicted %TWL at the 1-year and 3-year follow-up. Multiple regression analysis showed that these parameters were independent predictors of %EWL and %TWL at 1 year, while preoperative weight and excess weight also independently predicted %EWL at the 3-year follow-up. In diabetic patients, %EWL was significantly lower at the 3-year follow-up and %TWL was significantly lower at the 1-year and 3-year follow-up. Conclusion SG LDJB was an effective bariatric surgery to treat obesity. Preoperative BMI, weight, excess weight, and the presence of diabetes were the significant factors associated with the weight loss outcomes.

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Endoscopic intragastric injection of botulinum toxin in the treatment of patients with morbid obesity: opportunities and prospects

Aliyev¹,

Mamedova²,

Алиев³

2023

Khir. Z. im. N.I. Pirogova

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Laparoscopic Biliopancreatic Diversion with Duodenal Switch - The Most Effective Operation for Type 2 Diabetes Mellitus. How I do it?

Cited by 3 publications

References 17 publications

Safety and Feasibility of Laparoscopic Sleeve Gastrectomy with Loop Duodenal Switch Surgery for Obesity in Indian Patients

Safety and Feasibility of Laparoscopic Sleeve Gastrectomy with Loop Duodenal Switch Surgery for Obesity in Indian Patients

Factors Predicting Weight Loss after “Sleeve Gastrectomy with Loop Duodenojejunal Bypass” Surgery for Obesity

Endoscopic intragastric injection of botulinum toxin in the treatment of patients with morbid obesity: opportunities and prospects

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