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Published in: World Journal of Surgery 4/2020

01-04-2020 | Malnutrition | Original Scientific Report with Video

Reversing One-Anastomosis Gastric Bypass Surgery due to Severe and Refractory Hypoalbuminemia

Authors: Behrouz Keleidari, Mohsen Mahmoudieh, Shahab Shahabi, Erfan Sheikhbahaei, Mohammadtaghi Rezaei, Masoud Sayadi, Hamid Melali

Published in: World Journal of Surgery | Issue 4/2020

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Abstract

Background

Laparoscopic one-anastomosis gastric bypass (LOAGB) has to be reverse under some circumstances. This study is aimed to introduce and review a series of LOAGB cases that had to be reversed to normal anatomy due to severe hypoalbuminemia and its related symptoms after a few months.

Methods

Patients who had LOAGB from 2014 to 2018 and then reversed after some months were included in this study. Their first and second surgical data were collected and reviewed for important and relevant information.

Results

From 846 cases of LOAGB, 12 patients reversed after a mean of 12.1 months. All of them were women with mean age of 46 years. All of the gastrojejunostomy anastomosis had been made 200 cm after the Treitz ligament, and all of the patients had at least 250 cm common channel. The mean excess body mass index loss before the reversal surgery was 107.7%. None patients lost or died during the study.

Conclusion

Regarding anastomosis, 200 cm from Treitz ligament is not suitable for all of the patients and common channel more than 250 cm cannot prevent hypoalbuminemia. The surgeon should decide as quickly as possible whether his/her patients need reversal surgery or not. Appropriate patients should be selected for LOAGB.
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Literature
2.
go back to reference Lee WJ, Lee YC, Ser KH, Chen SC, Chen JC, Su YH (2011) Revisional surgery for laparoscopic minigastric bypass. Surg Obes Relat Dis 7(4):486–490CrossRef Lee WJ, Lee YC, Ser KH, Chen SC, Chen JC, Su YH (2011) Revisional surgery for laparoscopic minigastric bypass. Surg Obes Relat Dis 7(4):486–490CrossRef
3.
go back to reference Victorzon M (2015) Single-anastomosis gastric bypass: better, faster, and safer? Scand J Surg 104(1):48–53CrossRef Victorzon M (2015) Single-anastomosis gastric bypass: better, faster, and safer? Scand J Surg 104(1):48–53CrossRef
4.
go back to reference Pinto-Bastos A, Conceição EM, Machado PPP (2017) Reoperative bariatric surgery: a systematic review of the reasons for surgery, medical and weight loss outcomes, relevant behavioral factors. Obes Surg 27(10):2707–2715CrossRef Pinto-Bastos A, Conceição EM, Machado PPP (2017) Reoperative bariatric surgery: a systematic review of the reasons for surgery, medical and weight loss outcomes, relevant behavioral factors. Obes Surg 27(10):2707–2715CrossRef
6.
go back to reference Patel S, Szomstein S, Rosenthal RJ (2011) Reasons and outcomes of reoperative bariatric surgery for failed and complicated procedures (excluding adjustable gastric banding). Obes Surg 21(8):1209–1219CrossRef Patel S, Szomstein S, Rosenthal RJ (2011) Reasons and outcomes of reoperative bariatric surgery for failed and complicated procedures (excluding adjustable gastric banding). Obes Surg 21(8):1209–1219CrossRef
8.
go back to reference Lee WJ, Lin YH (2014) Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg 24(10):1749–1756CrossRef Lee WJ, Lin YH (2014) Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg 24(10):1749–1756CrossRef
9.
go back to reference Rutledge R, Walsh TR (2005) Continued excellent results with the mini-gastric bypass: 6-year study in 2410 patients. Obes Surg 15(9):1304–1308CrossRef Rutledge R, Walsh TR (2005) Continued excellent results with the mini-gastric bypass: 6-year study in 2410 patients. Obes Surg 15(9):1304–1308CrossRef
10.
go back to reference Rutledge R (2001) The mini-gastric bypass: experience with the first 1274 cases. Obes Surg 11(3):276–280CrossRef Rutledge R (2001) The mini-gastric bypass: experience with the first 1274 cases. Obes Surg 11(3):276–280CrossRef
13.
go back to reference Genser L, Soprani A, Tabbara M, Siksik JM, Cady J, Carandina S (2017) Laparoscopic reversal of mini-gastric bypass to original anatomy for severe postoperative malnutrition. Langenbeck’s Arch Surg 402(8):1263–1270CrossRef Genser L, Soprani A, Tabbara M, Siksik JM, Cady J, Carandina S (2017) Laparoscopic reversal of mini-gastric bypass to original anatomy for severe postoperative malnutrition. Langenbeck’s Arch Surg 402(8):1263–1270CrossRef
14.
go back to reference Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK (2013) “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg 23(11):1890–1898CrossRef Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK (2013) “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg 23(11):1890–1898CrossRef
15.
go back to reference Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ (2017) Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg 27(5):1153–1167CrossRef Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ (2017) Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg 27(5):1153–1167CrossRef
16.
go back to reference Mahawar KK, Carr WRJ, Balupuri S, Small PK (2014) Controversy surrounding “mini” gastric bypass. Obes Surg 24(2):324–333CrossRef Mahawar KK, Carr WRJ, Balupuri S, Small PK (2014) Controversy surrounding “mini” gastric bypass. Obes Surg 24(2):324–333CrossRef
17.
go back to reference Musella M, Susa A, Manno E, De Luca M, Greco F, Raffaelli M et al (2017) Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg 27(11):2956–2967CrossRef Musella M, Susa A, Manno E, De Luca M, Greco F, Raffaelli M et al (2017) Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg 27(11):2956–2967CrossRef
18.
go back to reference Chevallier JM, Arman GA, Guenzi M, Rau C, Bruzzi M, Beaupel N et al (2015) One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg 25(6):951–958CrossRef Chevallier JM, Arman GA, Guenzi M, Rau C, Bruzzi M, Beaupel N et al (2015) One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg 25(6):951–958CrossRef
19.
20.
go back to reference Mahawar KK, Parmar C, Carr WR, Jennings N, Schroeder NSP (2018) Impact of biliopancreatic limb length on severe protein–calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass. J Min Access Surg 14(1):37–43CrossRef Mahawar KK, Parmar C, Carr WR, Jennings N, Schroeder NSP (2018) Impact of biliopancreatic limb length on severe protein–calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass. J Min Access Surg 14(1):37–43CrossRef
21.
go back to reference Eilenberg M, Langer FB, Beer A, Trauner M, Prager G, Staufer K (2018) Significant liver-related morbidity after bariatric surgery and its reversal—a case series. Obes Surg 28(3):812–819CrossRef Eilenberg M, Langer FB, Beer A, Trauner M, Prager G, Staufer K (2018) Significant liver-related morbidity after bariatric surgery and its reversal—a case series. Obes Surg 28(3):812–819CrossRef
23.
go back to reference Almalki OM, Lee WJ, Chen JC, Ser KH, Lee YC, Chen SC (2018) Revisional gastric bypass for failed restrictive procedures: comparison of single-anastomosis (mini-) and Roux-en-Y gastric bypass. Obes Surg 28(4):970–975CrossRef Almalki OM, Lee WJ, Chen JC, Ser KH, Lee YC, Chen SC (2018) Revisional gastric bypass for failed restrictive procedures: comparison of single-anastomosis (mini-) and Roux-en-Y gastric bypass. Obes Surg 28(4):970–975CrossRef
24.
go back to reference Dapri G, Cadière GB, Himpens J (2011) Laparoscopic reconversion of Roux-en-Y gastric bypass to original anatomy: technique and preliminary outcomes. Obes Surg 21(8):1289–1295CrossRef Dapri G, Cadière GB, Himpens J (2011) Laparoscopic reconversion of Roux-en-Y gastric bypass to original anatomy: technique and preliminary outcomes. Obes Surg 21(8):1289–1295CrossRef
25.
go back to reference Himpens J, Dapri G, Cadière GB (2006) Laparoscopic conversion of the gastric bypass into a normal anatomy. Obes Surg 16(7):908–912CrossRef Himpens J, Dapri G, Cadière GB (2006) Laparoscopic conversion of the gastric bypass into a normal anatomy. Obes Surg 16(7):908–912CrossRef
Metadata
Title
Reversing One-Anastomosis Gastric Bypass Surgery due to Severe and Refractory Hypoalbuminemia
Authors
Behrouz Keleidari
Mohsen Mahmoudieh
Shahab Shahabi
Erfan Sheikhbahaei
Mohammadtaghi Rezaei
Masoud Sayadi
Hamid Melali
Publication date
01-04-2020
Publisher
Springer International Publishing
Keyword
Malnutrition
Published in
World Journal of Surgery / Issue 4/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05290-7

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