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- Title
Pylorus preserving loop duodeno-enterostomy with sleeve gastrectomy - preliminary results.
- Authors
Grueneberger, Jodok Matthias; Karcz-Socha, Iwona; Marjanovic, Goran; Kuesters, Simon; Zwirska-Korczala, Krystyna; Schmidt, Katharina; Karcz, W. Konrad
- Abstract
Background Bariatric operations mostly combine a restrictive gastric component with a rerouting of the intestinal passage. The pylorus can thereby be alternatively preserved or excluded. With the aim of performing a "pylorus-preserving gastric bypass", we present early results of a proximal postpyloric loop duodeno-jejunostomy associated with a sleeve gastrectomy (LSG) compared to results of a parallel, but distal LSG with a loop duodeno-ileostomy as a two-step procedure. Methods 16 patients underwent either a two-step LSG with a distal loop duodeno-ileostomy (DIOS) as revisional bariatric surgery or a combined single step operation with a proximal duodenojejunostomy (DJOS). Total small intestinal length was determined to account for interindividual differences. Results Mean operative time for the second-step of the DIOS operation was 121 min and 147 min for the combined DJOS operation. The overall intestinal length was 750.8 cm (range 600-900 cm) with a bypassed limb length of 235.7 cm in DJOS patients. The mean length of the common channel in DIOS patients measured 245.6 cm. Overall excess weight loss (%EWL) of the two-step DIOS procedure came to 38.31% and 49.60 %, DJOS patients experienced an %EWL of 19.75 % and 46.53 % at 1 and 6 months, resp. No complication related to the duodeno-enterostomy occurred. Conclusions Loop duodeno-enterosomies with sleeve gastrectomy can be safely performed and may open new alternatives in bariatric surgery with the possibility for inter-individual adaptation.
- Subjects
PYLORUS; GASTRECTOMY; BARIATRIC surgery; JEJUNOSTOMY; DUODENECTOMY; GASTRIC bypass
- Publication
BMC Surgery, 2014, Vol 14, Issue 1, p1
- ISSN
1471-2482
- Publication type
Article
- DOI
10.1186/1471-2482-14-20