Tags

Type your tag names separated by a space and hit enter

Technical Options for Malabsorption Issues After Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy.
Obes Surg. 2017 12; 27(12):3344-3348.OS

Abstract

BACKGROUND

Laparoscopic single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) is a recently developed one- or two-stage operation based on biliopancreatic diversion that is used to treat morbid obesity. Some midterm outcomes suggest that malabsorption is a possible complication following the procedure. Therefore, conversion to a less malabsorptive procedure may be required. We aim to describe and analyze the outcomes after laparoscopic conversion of SADI-S to non-malabsorptive or less malabsorptive procedures.

METHODS

From January 2015 to April 2017, five patients underwent laparoscopic conversion to single anastomosis duodenojejunal bypass with sleeve gastrectomy (SADJ-S) (video) following SADI-S, and one female patient underwent laparoscopic conversion to gastric bypass (GBP) following SADI-S, after presenting with severe protein-calorie malnutrition, nutritional deficiencies, poor quality of life, or increased number of bowel movements.

RESULTS

Mean preoperative BMI was 24.0 kg/m2 (20.4-27.5 kg/m2). Four patients underwent SADI-S to SADJ-S conversions and one underwent a SADI-S to Roux-en-Y duodenojejunal bypass. All cases were performed laparoscopically. No relevant postoperative complications or mortality was reported and the mean hospital stay was 4.6 days. Malabsorptive symptoms resolved in all patients. All patients experienced weight regain. Mean BMI increase was 7.1 kg/m2 (5-10.8 kg/m2).

CONCLUSIONS

Outcomes of laparoscopic conversion to SADJ-S or GBP after SADI-S were acceptable, showing clinical improvement of malnutrition, nutritional deficiencies, and quality of life in all cases. Weight regain must be advised. These techniques appear feasible and free of severe long-term complications. Further investigation is warranted to understand the best common channel length for patients undergoing SADI-S.

Authors+Show Affiliations

Endocrine, Metabolic and Bariatric Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain. vilallongapuy@hotmail.com.Endocrine, Metabolic and Bariatric Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.Endocrine, Metabolic and Bariatric Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.Endocrine, Metabolic and Bariatric Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.Endocrine, Metabolic and Bariatric Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.Endocrinolgy and Nutrition Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, CIBER Instituto de Salud Carlos III, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.Endocrinolgy and Nutrition Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.Endocrine, Metabolic and Bariatric Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain.

Pub Type(s)

Case Reports
Journal Article
Video-Audio Media

Language

eng

PubMed ID

28952026

Citation

Vilallonga, Ramon, et al. "Technical Options for Malabsorption Issues After Single Anastomosis Duodenoileal Bypass With Sleeve Gastrectomy." Obesity Surgery, vol. 27, no. 12, 2017, pp. 3344-3348.
Vilallonga R, Balibrea JM, Curell A, et al. Technical Options for Malabsorption Issues After Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy. Obes Surg. 2017;27(12):3344-3348.
Vilallonga, R., Balibrea, J. M., Curell, A., Gonzalez, O., Caubet, E., Ciudin, A., Ortiz-Zúñiga, A. M., & Fort, J. M. (2017). Technical Options for Malabsorption Issues After Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy. Obesity Surgery, 27(12), 3344-3348. https://doi.org/10.1007/s11695-017-2931-z
Vilallonga R, et al. Technical Options for Malabsorption Issues After Single Anastomosis Duodenoileal Bypass With Sleeve Gastrectomy. Obes Surg. 2017;27(12):3344-3348. PubMed PMID: 28952026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Technical Options for Malabsorption Issues After Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy. AU - Vilallonga,Ramon, AU - Balibrea,José Maria, AU - Curell,Anna, AU - Gonzalez,Oscar, AU - Caubet,Enric, AU - Ciudin,Andrea, AU - Ortiz-Zúñiga,Angel Michael, AU - Fort,José Manuel, PY - 2017/9/28/pubmed PY - 2018/5/1/medline PY - 2017/9/28/entrez KW - Complication KW - Conversion KW - Malabsorption KW - Revisional procedure KW - SADI-S SP - 3344 EP - 3348 JF - Obesity surgery JO - Obes Surg VL - 27 IS - 12 N2 - BACKGROUND: Laparoscopic single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) is a recently developed one- or two-stage operation based on biliopancreatic diversion that is used to treat morbid obesity. Some midterm outcomes suggest that malabsorption is a possible complication following the procedure. Therefore, conversion to a less malabsorptive procedure may be required. We aim to describe and analyze the outcomes after laparoscopic conversion of SADI-S to non-malabsorptive or less malabsorptive procedures. METHODS: From January 2015 to April 2017, five patients underwent laparoscopic conversion to single anastomosis duodenojejunal bypass with sleeve gastrectomy (SADJ-S) (video) following SADI-S, and one female patient underwent laparoscopic conversion to gastric bypass (GBP) following SADI-S, after presenting with severe protein-calorie malnutrition, nutritional deficiencies, poor quality of life, or increased number of bowel movements. RESULTS: Mean preoperative BMI was 24.0 kg/m2 (20.4-27.5 kg/m2). Four patients underwent SADI-S to SADJ-S conversions and one underwent a SADI-S to Roux-en-Y duodenojejunal bypass. All cases were performed laparoscopically. No relevant postoperative complications or mortality was reported and the mean hospital stay was 4.6 days. Malabsorptive symptoms resolved in all patients. All patients experienced weight regain. Mean BMI increase was 7.1 kg/m2 (5-10.8 kg/m2). CONCLUSIONS: Outcomes of laparoscopic conversion to SADJ-S or GBP after SADI-S were acceptable, showing clinical improvement of malnutrition, nutritional deficiencies, and quality of life in all cases. Weight regain must be advised. These techniques appear feasible and free of severe long-term complications. Further investigation is warranted to understand the best common channel length for patients undergoing SADI-S. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/28952026/Technical_Options_for_Malabsorption_Issues_After_Single_Anastomosis_Duodenoileal_Bypass_with_Sleeve_Gastrectomy_ L2 - https://dx.doi.org/10.1007/s11695-017-2931-z DB - PRIME DP - Unbound Medicine ER -