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- Title
Conversions of Roux-en-Y gastric bypass to duodenal switch (SADI-S and BPD-DS) for weight regain.
- Authors
Moon, Rena C.; Alkhairi, Layth; Wier, Alyssa Jameson; Teixeira, Andre F.; Jawad, Muhammad A.
- Abstract
<bold>Background: </bold>Duodenal switch is a choice of conversion when patients fail to lose or regain weight after Roux-en-Y gastric bypass (RYGB). This study aims to evaluate the effectiveness and safety of duodenal switch as a secondary operation for patients who presented with insufficient weight loss or weight regain after a RYGB.<bold>Methods: </bold>A retrospective chart review was performed on 15 patients who underwent a conversion of RYGB to single anastomosis duodeno-ileal bypass with sleeve (SADI-S) or biliopancreatic diversion with duodenal switch (BPD-DS) due to weight regain between December 31, 2013 and October 31, 2018. For the body mass index (BMI) analysis, the multilevel model for change was used.<bold>Results: </bold>Of 15 patients, 10 underwent a conversion to SADI-S, and 5 underwent a conversion to BPD-DS. Also, 7 patients underwent the conversion in two-stages, while 8 did as single-stage. One patient had a duodenal stump leak after SADI-S, and another patient had a sleeve leak after BPD-DS. One patient underwent a reoperation to increase the common channel 20 months after the conversion to BPD-DS due to malnutrition. There was no mortality. Mean percentage of total weight loss (TWL) was 18.4% at 6 months, 25.0% at 12 months, 26.4% at 18 months, and 25.7% at 24 months after the conversion. The rate of decrease in BMI was slower in SADI-S patients than in BPD-DS patients (p < 0.01), adjusting for preoperative BMI.<bold>Conclusion: </bold>Conversions of RYGB to SADI-S and BPD-DS can provide significant additional weight loss. However, complications and malnutrition can develop after the conversion, and further research is needed for evaluating safety.
- Subjects
GASTRIC bypass; BILIOPANCREATIC diversion; BODY mass index; MULTILEVEL models; STAPLERS (Surgery); DUODENUM surgery; SURGICAL anastomosis; RETROSPECTIVE studies; SURGICAL complications; MORBID obesity; WEIGHT gain; DIGESTIVE organ surgery; WEIGHT loss; COMORBIDITY
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2020, Vol 34, Issue 10, p4422
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-019-07219-6