Revisional Surgery for Insufficient Loss or Regain of Weight After Roux-en-Y Gastric Bypass: Biliopancreatic Limb Length Matters.

Abstract:

INTRODUCTION:Weight regain after laparoscopic Roux-en-Y gastric bypass (RYGB) occurs in up to 35% of patients. Revisional surgery may be applied. Conversion from RYGB to a long biliopancreatic limb (BPL) RYGB is a potential option for revisional surgery and short-term results are promising. METHODS:All patients who underwent conversion to long BPL RYGB due to weight loss failure, defined as excess weight loss (EWL) < 50% or body mass index (BMI) > 35 kg/m2, were assessed. Proximal RYGB or very very long limb RYGB (VVLL RYGB) was modified by shortening of the total alimentary limb length (TALL) to create a long BPL. RESULTS:A total of 28 patients received revisional surgery from either PRYGB (n = 22) or VVLL RYGB (n = 6). Mean age at operation was 45.3 ± 10.4 years, with 78% females. Mean prerevisional BMI was 41.7 ± 4.4 kg/m2. Mean time to revision was 76.5 ± 38.5 months. Limb lengths were 150 cm (95% CI 133-156 cm) for RL and 100 cm (95% CI 97-113 cm) for CC, thus providing a total median alimentary limb length of 250 (95% CI 238-260 cm). Additional %EWL and TWL improved significantly in long-term. Five years postoperatively, all patients (n = 9) had an EWL% > 50%. Six patients (21.4%) required reoperation due to severe malnutrition during the postoperative course. CONCLUSION:Conversion from RYGB to BPL RYGB leads to significant additional weight loss in the long term. However, the morbidity is relevant, especially severe protein malnutrition and the frequency of revisional surgery. Therefore, this type of surgery should not be done routinely.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Kraljević M,Köstler T,Süsstrunk J,Lazaridis II,Taheri A,Zingg U,Delko T

doi

10.1007/s11695-019-04348-8

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

804-811

issue

3

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-019-04348-8

journal_volume

30

pub_type

杂志文章
  • A comparison of wedge and needle hepatic biopsy in open bariatric surgery.

    abstract:BACKGROUND:Morbidly obese patients, despite normal laboratory tests and no clinical evidence of liver disease, present a high prevalence of hepatic histological changes. Liver biopsy is able to provide the diagnosis, staging and assessment of follow-up of hepatic disease, thus helping to define clinical management. The...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089206775565159

    authors: Padoin AV,Mottin CC,Moretto M,Berleze D,Kupski C,Glock L,Reichel CL,da Silva VD,da Silva JB

    更新日期:2006-02-01 00:00:00

  • Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model.

    abstract:BACKGROUND:Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-015-1811-7

    authors: Wang K,Zhou X,Quach G,Lu J,Gao W,Xu A,Zhu J

    更新日期:2016-04-01 00:00:00

  • Vertical Gastroplasty with Artificial Pseudopylorus: A Modification in the Treatment of Morbid Obesity. Early Results.

    abstract::A new technique of vertical gastroplasty was applied in 50 morbidly obese patients. Eight of them were male and 42 female with a mean age of 34 years (range 2058). The mean excess body weight was 77 kg (range 52-133) and the mean Body Mass Index 51 kg/m(2) (range 42-81). Under direct vision the hepatogastric and gastr...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089294765558322

    authors: Aidonopoulos AP,Papavramidis ST

    更新日期:1994-11-01 00:00:00

  • Incidental Jejunal Lesion Necessitating Intraoperative Change of Plan During Bariatric Surgery: a Video Case Report.

    abstract::Incidental gastric and small bowel lesions are commonly encountered during bariatric surgery. Resection of these lesions with negative margins in the same sitting is curative; however, this may necessitate intraoperative change of plan. We present a 44-year-old super obese lady in whom an exophytic jejunal mass was fo...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-05162-3

    authors: Kumar A,Baksi A,Yadavalli SD,Aggarwal S

    更新日期:2021-01-19 00:00:00

  • Personality profiles of the morbidly obese after vertical banded gastroplasty.

    abstract:BACKGROUND:The authors attempted to determine if mental status could predict personality profiles, 18 months after surgery in morbidly obese patients. METHODS:Personality characteristics of 100 morbidly obese patients (85 female, 15 male) were analyzed after bariatric surgery (vertical banded gastroplasty). Patients w...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089203765887723

    authors: Guisado JA,Vaz FJ

    更新日期:2003-06-01 00:00:00

  • A Comparison of Health Professionals' and Patients' Views of the Importance of Outcomes of Bariatric Surgery.

    abstract:BACKGROUND:A comprehensive evaluation of bariatric surgery is required to inform decision-making. This will include measures of benefit and risk. It is possible that stakeholders involved with surgery value these outcomes differently, although this has not previously been explored. This study aimed to investigate and c...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-016-2186-0

    authors: Coulman KD,Howes N,Hopkins J,Whale K,Chalmers K,Brookes S,Nicholson A,Savovic J,Ferguson Y,Owen-Smith A,Blazeby J,By-Band-Sleeve Trial Management Group.,Blazeby J,Welbourn R,Byrne J,Donovan J,Reeves BC,Wordsworth S,An

    更新日期:2016-11-01 00:00:00

  • Does anatomy explain the origin of a leak after sleeve gastrectomy?

    abstract:BACKGROUND:Sleeve gastrectomy is a bariatric surgical procedure that may result in particular morbidity or mortality due to gastric fistula in the proximal part of the gastric tube. Two theories are currently proposed to explain this specific leak location. The vascular theory attributes the leaks to reduced perfusion ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-014-1256-4

    authors: Perez M,Brunaud L,Kedaifa S,Guillotin C,Gerardin A,Quilliot D,Grosdidier G,Reibel N

    更新日期:2014-10-01 00:00:00

  • Correction to: Clinical Practice Guidelines for Childbearing Female Candidates for Bariatric Surgery, Pregnancy, and Post-Partum Management after Bariatric Surgery.

    abstract::In the original article, due to an XML tagging error the name of Véronique Taillard was omitted from the list of members of the French Study Group for Bariatric Surgery and Maternity (the BARIA-MAT Group). The correct list is as follows. ...

    journal_title:Obesity surgery

    pub_type: 已发布勘误

    doi:10.1007/s11695-020-04479-3

    authors: Ciangura C,Coupaye M,Deruelle P,Gascoin G,Calabrese D,Cosson E,Ducarme G,Gaborit B,Lelièvre B,Mandelbrot L,Petrucciani N,Quilliot D,Ritz P,Robin G,Sallé A,Gugenheim J,Nizard J,BARIA-MAT Group.

    更新日期:2020-09-01 00:00:00

  • Laparoscopic Roux-en-Y gastric bypass: differences in outcome between attendings and assistants of different training backgrounds.

    abstract:BACKGROUND:Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is associated with a significant learning curve. We hypothesize that differences in surgeon and assistant training backgrounds may significantly impact outcomes during the learning curve. METHODS:Retrospective analysis was performed on patients undergoing LRYGB...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/0960892055002374

    authors: Hsu GP,Morton JM,Jin L,Safadi BY,Satterwhite TS,Curet MJ

    更新日期:2005-09-01 00:00:00

  • Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature.

    abstract::Ulcer disease in excluded segments after Roux-Y gastric bypass (RYGB) is rare but can evolve into a life-threatening situation. The excluded segments exhibit a different behavior from that of non-altered anatomy; perforated ulcers do not result in pneumoperitoneum or free fluid, and therefore must be met with a low th...

    journal_title:Obesity surgery

    pub_type: 杂志文章,评审

    doi:10.1007/s11695-020-05123-w

    authors: Plitzko G,Schmutz G,Kröll D,Nett PC,Borbély Y

    更新日期:2020-11-24 00:00:00

  • 30-day readmission rates at a high volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass.

    abstract:BACKGROUND:Recent studies suggest that weight loss operations may actually increase the costs to society due to increased hospital readmission rates. The purpose of this study was to determine the 30-day readmission rates following bariatric operations at a high volume bariatric surgery program. METHODS:Records for al...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-007-9210-3

    authors: Saunders JK,Ballantyne GH,Belsley S,Stephens D,Trivedi A,Ewing DR,Iannace V,Capella RF,Wasielewski A,Moran S,Schmidt HJ

    更新日期:2007-09-01 00:00:00

  • Small bowel obstruction and internal hernias during pregnancy after gastric bypass surgery.

    abstract::Small bowel obstruction (SBO) is a recognized complication of Roux-en-Y gastric bypass (RYGB) surgery. Internal hernia (IH) a potential problem associated with RYGB, can have severe consequences if not diagnosed. We present two cases of SBO due to IH during pregnancy after laparoscopic RYGB (LRYGB). Both patients unde...

    journal_title:Obesity surgery

    pub_type: 杂志文章,评审

    doi:10.1007/s11695-008-9681-x

    authors: Torres-Villalobos GM,Kellogg TA,Leslie DB,Antanavicius G,Andrade RS,Slusarek B,Prosen TL,Ikramuddin S

    更新日期:2009-07-01 00:00:00

  • Bariatric surgery: low mortality at a high-volume center.

    abstract:BACKGROUND:The American Society of Bariatric Surgery has initiated a Bariatric Surgery Center of Excellence Program and the American College of Surgeons has followed with their Bariatric Surgery Center Network Accreditation Program. These programs postulate that concentration of weight loss operations in high-volume ce...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-007-9357-y

    authors: Ballantyne GH,Belsley S,Stephens D,Saunders JK,Trivedi A,Ewing DR,Iannace V,Davis D,Capella RF,Wasielewski A,Moran S,Schmidt HJ

    更新日期:2008-06-01 00:00:00

  • Outcome of pregnancies after biliopancreatic diversion.

    abstract:BACKGROUND:Severe obesity has deleterious effects on fertility and pregnancy outcomes. Although surgery is the best long-term treatment for severe obesity, there is a risk of gestational undernutrition in operated mothers because bariatric surgery reduces nutrient availability. This is a follow-up report of our initial...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089204322917819

    authors: Marceau P,Kaufman D,Biron S,Hould FS,Lebel S,Marceau S,Kral JG

    更新日期:2004-03-01 00:00:00

  • Trocar Injuries in 17,446 Laparoscopic Gastric Bypass-a Nationwide Survey from the Scandinavian Obesity Surgery Registry.

    abstract:BACKGROUND:Although, the vast majority of bariatric procedures worldwide are performed laparoscopically, there is no consensus on the best technique to enter the first trocar, a potentially dangerous maneuver. Three principally different techniques exist: initial pneumoperitoneum by Verres needle, open Hasson technique...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-016-2080-9

    authors: Sundbom M,Ottosson J

    更新日期:2016-09-01 00:00:00

  • Clinical Characteristics and Outcome of Morbidly Obese Bariatric Patients with Concurrent Hepatitis C Viral Infection.

    abstract:BACKGROUND:Hepatitis C virus (HCV) is an important cause of liver cirrhosis and its complications. The safety and efficacy of bariatric surgery in patients with HCV infection is not clear. METHODS:Charts were reviewed to identify patients with HCV infection before bariatric surgery. Bariatric surgical patients with no...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-018-3615-z

    authors: Han ML,Lee WJ,Chen JC,Ser KH,Chen SC,Lee YC

    更新日期:2019-03-01 00:00:00

  • Incidental Gastrointestinal Stromal Tumors (GISTs) and Bariatric Surgery: A Review.

    abstract::The number of bariatric procedures has increased notably, with incidental findings such as gastrointestinal stromal tumors (GISTs) being observed in 2%. The number of studies dealing with incidental findings during bariatric surgery (BS), especially GISTs, is scarce. This review aims to summarize the evidence about GI...

    journal_title:Obesity surgery

    pub_type: 杂志文章,评审

    doi:10.1007/s11695-020-04853-1

    authors: Fernández JA,Frutos MD,Ruiz-Manzanera JJ

    更新日期:2020-11-01 00:00:00

  • Early experience with computer-mediated flexible circular stapling technique for upper gastrointestinal anastomosis.

    abstract:BACKGROUND:Creating the proximal anastomosis in laparoscopic biliopancreatic diversion with duodenal switch (LBPD-DS) and Roux-en-Y gastric bypass (LRYGBP) is a critical step in ensuring the success of the procedures. The aim of this study was to assess the safety and efficiency of performing this anastomosis using a f...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089203321136656

    authors: Waage A,Gagner M,Feng JJ

    更新日期:2003-02-01 00:00:00

  • What Is the Role of the New Index Relative Fat Mass (RFM) in the Assessment of Nonalcoholic Fatty Liver Disease (NAFLD)?

    abstract:INTRODUCTION:Nonalcoholic fatty liver disease (NAFLD) is the liver manifestation of adiposopathy. Recently, a new score was developed to estimate body fat percentage (relative fat mass, RFM). We aimed to evaluate the value of RFM in predicting the presence and severity of NAFLD, compared with other anthropometric measu...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-019-04213-8

    authors: Machado MV,Policarpo S,Coutinho J,Carvalhana S,Leitão J,Carvalho A,Silva AP,Velasco F,Medeiros I,Alves AC,Bourbon M,Cortez-Pinto H

    更新日期:2020-02-01 00:00:00

  • Voice feature characteristic in morbid obese population.

    abstract:BACKGROUND:Morbid obesity is highly prevalent in the Western World, and its consequences present a real public health challenge. Voice alterations can represent one of these consequences and represent an opportunity for interference with therapeutic methods. This particularly features of the individual's voice was the ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-009-9959-7

    authors: da Cunha MG,Passerotti GH,Weber R,Zilberstein B,Cecconello I

    更新日期:2011-03-01 00:00:00

  • Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch.

    abstract:BACKGROUND:The revisional surgery for patients with inadequate weight loss after biliopancreatic diversion with duodenal switch (BPD/DS) is controversial. It has not yet been determined whether a common channel should be shortened or gastric pouch volume reduced. Since the revision of the distal anastomosis remains tec...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089203322190907

    authors: Gagner M,Rogula T

    更新日期:2003-08-01 00:00:00

  • Pregnancy after Lap-Band surgery: management of the band to achieve healthy weight outcomes.

    abstract:BACKGROUND:Severely obese women have higher obstetric risks and poorer neonatal outcomes. Weight loss reduces obstetric risk. The introduction of a laparoscopically-placed adjustable gastric band, a safe and effective method of weight loss, has given us the ability and responsibility to adjust the band in relation to p...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089201321454123

    authors: Dixon JB,Dixon ME,O'Brien PE

    更新日期:2001-02-01 00:00:00

  • The impact of various anthropometric measurements of obesity on pulmonary function in candidates for surgery.

    abstract:BACKGROUND:Obesity has proven to be associated with respiratory symptoms and impaired pulmonary function, which could increase the incidence of postoperative complications after bariatric surgery. However, the component of obesity that has the most influence on pulmonary function has not been identified, especially in ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-009-9961-0

    authors: Wei YF,Wu HD,Chang CY,Huang CK,Tai CM,Hung CM,Tseng WK,Wu CC

    更新日期:2010-05-01 00:00:00

  • Endoscopic Ultrasound (EUS)-Guided Drainage of a Postsleeve Gastrectomy Subphrenic Collection Using a Lumen Apposition Stent.

    abstract::Sleeve gastrectomy is currently the most frequently performed bariatric surgery. Postoperative leaks represent the main cause of morbidity in up to 8% of patients with a mortality rate ranging between 0.1 and 5%. However, management of these leaks remains controversial. We report the case of a patient presenting with ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-04553-w

    authors: Machlab S,Pascua-Solé M,Hernández L,Lira A,Vives J,Pedregal P,Luna A,Junquera F

    更新日期:2020-08-01 00:00:00

  • Simultaneous gastric band removal and sleeve gastrectomy: a comparison with front-line sleeve gastrectomy.

    abstract::The placement of a gastric band (GB) prior to a sleeve gastrectomy (LSG) would increase postoperative complications, whether it is withdrawn or not at the time of the LSG. The purpose of this retrospective study was to evaluate and compare postoperative morbidity and outcome weight for simultaneous GB removal (RGB) an...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-012-0689-x

    authors: Rebibo L,Mensah E,Verhaeghe P,Dhahri A,Cosse C,Diouf M,Regimbeau JM

    更新日期:2012-09-01 00:00:00

  • Diagnostic medical radiation dose in patients after laparoscopic bariatric surgery.

    abstract:BACKGROUND:The purpose of this study was to estimate the cumulative radiation dose from computed tomography (CT) scans and upper gastrointestinal fluoroscopic exams in the post-bariatric-surgery population and correlate these values with current concepts of potential radiation-induced cancer risk. METHODS:A retrospect...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-009-9966-8

    authors: Oei TN,Shyn PB,Govindarajulu U,Flint R

    更新日期:2010-05-01 00:00:00

  • Effects and Mechanisms of Vagal Nerve Stimulation on Body Weight in Diet-Induced Obese Rats.

    abstract:BACKGROUND:Vagal nerve stimulation (VNS) has recently been indicated as a novel method for treating obesity. However, the optimal stimulation parameters were unknown and mechanisms were poorly understood. The aim of this study was to investigate the effects of VNS on food intake and body weight in diet-induced obesity ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-019-04365-7

    authors: Dai F,Yin J,Chen JDZ

    更新日期:2020-03-01 00:00:00

  • Incidence of cancer following bariatric surgery: systematic review and meta-analysis.

    abstract::Obesity is linked to the development of cancer. Previous studies have suggested that there is a relationship between bariatric surgery and reduced cancer risk. Data sources were from Medline, Embase, and Cochrane Library. From 951 references, 13 studies met the inclusion criteria (54,257 participants). In controlled s...

    journal_title:Obesity surgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s11695-014-1276-0

    authors: Casagrande DS,Rosa DD,Umpierre D,Sarmento RA,Rodrigues CG,Schaan BD

    更新日期:2014-09-01 00:00:00

  • Predicting outcomes of intermediate term complications and revisional surgery following laparoscopic adjustable gastric banding: utility of the CORE classification and Melbourne motility criteria.

    abstract:BACKGROUND:Patients with laparoscopic adjustable gastric bands (LAGB) present at times with adverse symptoms or unsatisfactory weight loss, where a liquid contrast swallow or upper gastrointestinal endoscopy is not diagnostic. Stress barium and high resolution manometry are promising investigations, however, have not y...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-010-0258-0

    authors: Burton PR,Brown WA,Laurie C,Hebbard G,O'Brien PE

    更新日期:2010-11-01 00:00:00

  • Quality of Life and Bariatric Surgery: Cross-Sectional Study and Analysis of Factors Influencing Outcome.

    abstract:PURPOSE:The aims of our study were to compare quality of life (QOL) in obese patients after bariatric surgery with that in controls seeking surgery and to investigate which factors are associated with QOL in the Moorehead-Ardelt Quality of Life Questionnaire II (MA II). MATERIALS AND METHODS:This was a cross-sectional...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-016-2220-2

    authors: Janik MR,Rogula T,Bielecka I,Kwiatkowski A,Paśnik K

    更新日期:2016-12-01 00:00:00