The Bianchi procedure: a 20-year single institution experience

First Report of the International Serial Transverse Enteroplasty Data Registry: Indications, Efficacy, and Complications

“…When compared with single-surgeon or single-institution outcomes after longitudinal intestinal lengthening and tapering (Bianchi procedure), our cohort demonstrated less overall mortality (7.9% compared with 55% or 21%) and less overall progression to transplantation (7.9% compared with 47% in the series from Pittsburgh). 20,21 Differences obviously exist between the two groups of patients because of improvements in overall health care and the multicenter nature of the STEP Registry, but the improved outcomes are striking. In addition to these comparative outcomes, these STEP Registry data note another important outcome: the ability of three patients who were previously listed for transplantation to be fully weaned from total parenteral nutrition, obviating the need for transplantation.…”

Improvement in the quality of life using both Bianchi’s procedure and the closure of a jejunostomy in a case with short bowel syndrome

“…Over one hundred cases with SBS have been reported regarding Bianchi's procedure and most of cases were either infant cases, who were less than 1 year of age, or adult cases [1][2][3][4][5][6][7][8]. SBS cases occurring in the adolescent period tend to be rare, as was our case.…”

“…For such SBS cases, the intestinal lengthening procedure, such as Bianchi's procedure [4] or serial transverse enteroplasty [11], is often surgically attempted to hasten the induction of intestinal adaptation [1][2][3]. Although the prognosis after those procedures has been well reported in the literature [3,[5][6][7][8], the chronological changes in nutritional markers have still not been fully evaluated during the period from the performance of the procedure until the discontinuation of PN. We experienced an SBS case, who demonstrated an improvement in the QOL after Bianchi's procedure with a closure of the jejunostomy and investigated the chronological change in the nutritional markers during the period from the time before the procedure until the time of discontinuing PN.…”

“…The weaning rate of PN is known to be 40-50% in the cases who have undergone this procedure alone [3,[5][6][7][8]. However, the timing of performance of this procedure remains controversial in the literature [1][2][3]8].…”

“…In the literature, the longitudinal intestinal lengthening using Bianchi's procedure [4] has thus been recommended in order to promote intestinal adaptation after the occurrence of SBS [1][2][3]. However, although this procedure is known to be effective for the intestinal adaptation [3,[5][6][7][8], the detailed chronological changes in nutritional condition have not yet been fully investigated.…”