Laparoscopic Conversion of Sleeve Gastrectomy to One Anastomosis Gastric Bypass for Weight Loss Failure: Mid-Term Results

Debs, Tarek; Petrucciani, Niccolò; Kassir, Radwan; Juglard, Gildas; Gugenheim, Jean; Iannelli, Antonio; Martini, Francesco; Liagre, Arnaud

doi:10.1007/s11695-020-04461-z

Cited by 37 publications

(44 citation statements)

References 38 publications

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“…The present study demonstrates that SADI is an effective revisional bariatric procedure after failed SG. However, a non-negligible rate of postoperative morbidity and mortality was observed in the present series, in comparison with previous published series on other revisional procedures after SG and other series of revisional SADI [10,11,38,39]. SADI is effective in patients with insufficient weight loss, or it may be scheduled after SG in patients with a very high BMI, in the setting of a two-step surgical strategy.…”

Section: Discussionsupporting

confidence: 61%

“…To avoid a potential source of additional postoperative complications, in our center, we avoid re-sleeving the gastric BMI, body mass index; EWL, excess weight loss; TWL, total weight loss; N., number pouch during SADI. When we perform OAGB after SG, we recalibrate the gastric tube systematically, increasing the restriction effect of the primary procedure [10]. In the absence of re-SG, the effect of secondary surgery relies only on the malabsorption effect; however, this may also be responsible for malnutrition.…”

Section: Discussionmentioning

confidence: 99%

“…Several revisional procedures are possible after SG, including conversion to Roux-en-Y gastric bypass (RYGB) [9], oneanastomosis gastric bypass (OAGB) [10], and duodenal switch (DS) [11]. Single-anastomosis duodeno-ileal bypass (SADI) has been proposed as an alternative to DS, with the advantages of a more simple procedure from a technical point of view, and a potentially reduced morbidity [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 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, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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“…The study was an observational trial without a matched control or randomization. Furthermore, the results of a center with a large experience of OAGB and management of its complications [20,39,40] may not be reproducible in low-volume or less experienced centers. Third, during the surgeries, the entire bowel length was not measured, as only the biliopancreatic limb was routinely measured.…”

Section: Limitsmentioning

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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“…45,46 The most frequent indications for revision are gastroesophageal reflux disease (GERD) and weight regain. 47…”

Section: Revisional Alternatives After Sleeve Gastrectomymentioning

confidence: 99%

Interventions for Weight Regain after Bariatric Surgery

Muñóz

Soto

2021

Digestive Disease Interventions

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Bariatric surgery is the most effective available treatment for obesity, inducing a significant and durable weight loss, and improving several obesity-associated diseases. However, as the number of bariatric surgeries performed increases, so does the prevalence of patients who experience either insufficient weight loss or weight regain, accompanied by relapse or the emergence of new obesity-related diseases. Endoscopic and surgical bariatric revisional procedures are used to promote weight loss and improve metabolic function to address these problems. After a psychological, nutritional, medical, and anatomical evaluation of the gastrointestinal anatomy has been completed, patient candidacy to a revisional procedure must be defined. In those patients with insufficient weight loss or weight regain associated with relapse, the emergence of new obesity-related diseases, or quality-of-life deterioration, a revisional procedure must be selected. Although current evidence comes mainly from observational and retrospective studies, with a limited number of patients and short follow-up times, the available data indicate that revisional procedures are useful to induce a significant weight loss and/or promote remission of obesity-associated diseases, albeit an increased risk of surgical and/or nutritional complications. Thus, careful selection of patients is needed to minimize risk and maximize the benefit of these procedures.

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Laparoscopic Conversion of Sleeve Gastrectomy to One Anastomosis Gastric Bypass for Weight Loss Failure: Mid-Term Results

Cited by 37 publications

References 38 publications

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

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

Interventions for Weight Regain after Bariatric Surgery

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