Purpose: Laparoscopic sleeve gastrectomy (SG) may be associated with long-term problems such as insufficient weight loss or weight regain, persistence or relapse of comorbidities, and gastroesophageal reflux disease (GERD). This study analyzes the outcome of patients that underwent conversion of SG to a gastric bypass procedure.
Materials And Methods: All patients that underwent conversion from SG to the following four different gastric bypass procedures were analyzed: short biliopancreatic limb (BPL) bypass types such as proximal Roux-en-Y gastric bypass (PRYGB) or type 2 distal Roux-en-Y gastric bypass (type 2 DRYGB) and long BPL types such as long BPL RYGB or one anastomosis gastric bypass (OAGB).
Results: Between 2012 and 2016, 52 patients received the following revisional procedures after primary SG: proximal RYGB (n = 12, 23.1%), type 2 DRYGB (n = 8, 15.4%), long BPL RYGB (n = 20, 38.5%), and OAGB (n = 12, 23.1%). The long BPL type procedures (long BPL RYGB, OAGB) resulted in a significant long-term additional %EWL (33.8%; 33.2%) at 3 years. In the PRYGB, the effect lasted only for 2 years. In all patients with GERD and dysphagia as the dominant post-SG symptoms, the conversion to a bypass procedure resulted in the complete resolution of these.
Conclusion: In case of weight regain or insufficient weight loss after SG, revisional surgery with a long BPL should be considered. The OAGB provides effective additional weight loss, with low morbidity and malnutrition rates, respectively. Conversion to the malabsorptive long BPL RYGB with a total alimentary limb length below 400 cm should be avoided. Patients that suffer primarily from post-SG GERD or dysphagia should undergo conversion to PRYGB.
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http://dx.doi.org/10.1007/s11695-020-04868-8 | DOI Listing |
Curr Obes Rep
January 2025
South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Background: One Anastomosis Gastric Bypass (OAGB) is a modification of Mason's loop bypass procedure, which has become a well-established procedure in the field of Bariatric and Metabolic surgery (BMS). However, the optimal length of Biliopancreatic Limb (BPL) in OAGB remains an ongoing debate.
Objective: This review aims to analyse the current trends and evidence regarding different BPL lengths in OAGB and their impact on outcomes.
Lasers Surg Med
January 2025
Candela Institute for Excellence, Marlborough, Massachusetts, USA.
Background: The non-ablative 1940-nm laser induces controlled thermal damage at superficial depths without ablating the epidermis.
Objective: We evaluated a new 1940-nm fractional diode laser for improving pigmentation and skin texture.
Materials And Methods: Participants with mild to severe benign pigmented lesions received up to three laser treatments.
Pulm Circ
October 2024
Department of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine Yale School of Medicine New Haven Connecticut USA.
Data from invasive CPET (iCPET) revealed long COVID patients have impaired systemic oxygen extraction (EO), suggesting impaired mitochondrial ATP production. However, it remains uncertain whether the initial severity of SARS-CoV-2 infection has implications on EO and exercise capacity (VO) nor has there been assessment of anerobic ATP generation in long COVID patients. iCPET was performed on 47 long COVID patients (i.
View Article and Find Full Text PDFObes Surg
December 2024
Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, Tampa, FL, 33606, USA.
It is well-established that extending either the biliopancreatic limb (BPL), the alimentary limb (AL), or both, results in increased combined bypass (CB) length, which in turn leads to enhanced weight loss and potential nutritional deficiencies due to heightened malabsorptive effects. However, a key question remains: Assuming no change in CB length, does altering BPL length affect outcomes? To address this question, we examined studies comparing long BPL and long AL (short BPL) while maintaining equal or nearly equal CB lengths. We conducted this systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
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