Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 8/2016

01-08-2016

Re-sleeve gastrectomy as revisional bariatric procedure after biliopancreatic diversion with duodenal switch

Authors: Philipp C. Nett, Dino Kröll, Yves Borbély

Published in: Surgical Endoscopy | Issue 8/2016

Login to get access

Abstract

Background

Re-sleeve gastrectomy (re-SG) is a possible option to increase weight loss after biliopancreatic diversion with duodenal switch (BPD-DS). We report the feasibility, efficacy and safety of re-SG in patients presenting with long-term weight regain after BPD-DS.

Methods

From October 2010 to December 2013, a total of 17 patients (12 female, 5 male) with a mean age of 42.1 ± 19.4 years underwent re-SG, mainly because of weight regain after BPD-DS. Re-SG was performed laparoscopically over a 32 French stomach tube.

Results

At the time of BPD-DS, the mean weight and BMI of all patients were 130.1 ± 17.9 kg and 46.1 ± 6.5 kg/m2, respectively. The mean time interval between BPD-DS and re-SG was 63.1 ± 20.3 months. At the time of re-SG, the mean weight and BMI were 115.4 ± 14.2 kg and 39.8 ± 5.3 kg/m2, and the %EWL after BPD-DS was 22.9 ± 17.4 %. Three conversions (17.6 %) to open surgery were required. No mortality occurred. One patient (5.9 %) developed a leak within the first week after re-SG that was treated conservatively with an endoluminal stent. The mean follow-up was 37.2 ± 7.1 months after re-SG. One- and three-year follow-up showed a mean weight, BMI, and cumulative %EWL of 96.0 ± 17.1 kg, 33.8 ± 7.3 kg/m2, and 53.1 ± 18.3 % (17/17 patients; 100 %), and 100.3 ± 21.1 kg, 35.1 ± 8.3 kg/m2, and 47.2 ± 19.7 % (13/17 patients; 76 %) after re-SG, respectively.

Conclusions

This study shows that re-SG in patients with weight regain after BPD-DS is a feasible, effective and safe option as a revisional bariatric procedure. However, patients have to be carefully considered for revisional surgery since re-SG is associated with the potential risk of surgical complications.
Literature
1.
2.
Marceau P, Biron S, Hould FS, Lebel S, Marceau S, Lescelleur O, Biertho L, Simard S (2009) Duodenal switch improved standard biliopancreatic diversion: a retrospective study. Surg Obes Relat Dis 5(1):43–47CrossRefPubMed
3.
Marceau P, Biron S, Marceau S, Hould FS, Lebel S, Lescelleur O, Biertho L, Simard S, Kral JG (2015) Long-term metabolic outcomes 5 to 20 years after biliopancreatic diversion. Obes Surg 25(9):1584–1593CrossRefPubMed
4.
5.
Dapri G, Cadiere GB, Himpens J (2011) Laparoscopic repeat sleeve gastrectomy versus duodenal switch after isolated sleeve gastrectomy for obesity. Surg Obes Relat Dis 7(1):38–43CrossRefPubMed
6.
Dapri G, Cadiere GB, Himpens J (2011) Laparoscopic conversion of Roux-en-Y gastric bypass to distal gastric bypass for weight regain. J Laparoendosc Adv Surg Tech A 21(1):19–23CrossRefPubMed
7.
Brethauer SA, Kothari S, Sudan R, Williams B, English WJ, Brengman M, Kurian M, Hutter M, Stegemann L, Kallies K, Nguyen NT, Ponce J, Morton JM (2014) Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis 10(5):952–972CrossRefPubMed
8.
Green DD, Engel SG, Mitchell JE (2014) Psychological aspects of bariatric surgery. Curr Opin Psychiatry 27(6):448–452CrossRefPubMed
9.
Tutuian R (2014) Effects of bariatric surgery on gastroesophageal reflux. Curr Opin Gastroenterol 30(4):434–438CrossRefPubMed
10.
Keidar A, Appelbaum L, Schweiger C, Elazary R, Baltasar A (2010) Dilated upper sleeve can be associated with severe postoperative gastroesophageal dysmotility and reflux. Obes Surg 20(2):140–147CrossRefPubMed
11.
12.
Topart PA, Becouarn G (2015) Revision and reversal after biliopancreatic diversion for excessive side effects or ineffective weight loss: a review of the current literature on indications and procedures. Surg Obes Relat Dis 11(4):965–972CrossRefPubMed
13.
Cesana G, Uccelli M, Ciccarese F, Carrieri D, Castello G, Olmi S (2014) Laparoscopic re-sleeve gastrectomy as a treatment of weight regain after sleeve gastrectomy. World J Gastrointest Surg 6(6):101–106PubMedPubMedCentral
14.
Parikh M, Gagner M (2008) Laparoscopic hiatal hernia repair and repeat sleeve gastrectomy for gastroesophageal reflux disease after duodenal switch. Surg Obes Relat Dis 4(1):73–75CrossRefPubMed
15.
Gagner M, Rogula T (2003) Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg 13(4):649–654CrossRefPubMed
16.
Biron S, Hould FS, Lebel S, Marceau S, Lescelleur O, Simard S, Marceau P (2004) Twenty years of biliopancreatic diversion: what is the goal of the surgery? Obes Surg 14(2):160–164CrossRefPubMed
17.
Shimizu H, Annaberdyev S, Motamarry I, Kroh M, Schauer PR, Brethauer SA (2013) Revisional bariatric surgery for unsuccessful weight loss and complications. Obes Surg 23(11):1766–1773CrossRefPubMed
18.
Noel P, Nedelcu M, Nocca D, Schneck AS, Gugenheim J, Iannelli A, Gagner M (2014) Revised sleeve gastrectomy: another option for weight loss failure after sleeve gastrectomy. Surg Endosc 28(4):1096–1102CrossRefPubMed
19.
Cambi MP, Marchesini SD, Baretta GA (2015) Post-bariatric surgery weight regain: evaluation of nutritional profile of candidate patients for endoscopic argon plasma coagulation. Arq Bras Cir Dig 28(1):40–43CrossRefPubMedPubMedCentral
20.
Bal BS, Finelli FC, Shope TR, Koch TR (2012) Nutritional deficiencies after bariatric surgery. Nat Rev Endocrinol 8(9):544–556CrossRefPubMed
21.
Shankar P, Boylan M, Sriram K (2010) Micronutrient deficiencies after bariatric surgery. Nutrition 26(11–12):1031–1037CrossRefPubMed
22.
Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, Heinberg LJ, Kushner R, Adams TD, Shikora S, Dixon JB, Brethauer S (2013) Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery. Obesity 21(Suppl 1):S1–S27CrossRefPubMedPubMedCentral
23.
Baltasar A, Serra C, Perez N, Bou R, Bengochea M (2006) Re-sleeve gastrectomy. Obes Surg 16(11):1535–1538CrossRefPubMed
24.
Vidal P, Ramon JM, Busto M, Dominguez-Vega G, Goday A, Pera M, Grande L (2014) Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg 24(3):359–363CrossRefPubMed
Metadata
Title
Re-sleeve gastrectomy as revisional bariatric procedure after biliopancreatic diversion with duodenal switch
Authors
Philipp C. Nett
Dino Kröll
Yves Borbély
Publication date
01-08-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4640-9

Other articles of this Issue 8/2016

Surgical Endoscopy 8/2016 Go to the issue

OriginalPaper

Dexmedetomidine versus morphine infusion following laparoscopic bariatric surgery: effect on supplemental narcotic requirement during the first 24 h

SAGES REVIEW ARTICLE

Surgical simulation: the value of individualization

OriginalPaper

Sutureless onlay hernia repair: a review of 97 patients

OriginalPaper

Is laparoscopic repair of incarcerated abdominal hernias safe? Analysis of short-term outcomes

OriginalPaper

A novel approach of optical biopsy using probe-based confocal laser endomicroscopy for peritoneal metastasis

OriginalPaper

Face, content, construct, and concurrent validity of a novel robotic surgery patient-side simulator: the Xperience™ Team Trainer