Reoperation After Loop Duodenojejunal Bypass with Sleeve Gastrectomy: A 9-Year Experience

Overview

Journal Obes Surg

Date 2024 Jun 13

PMID 38869832

Authors

Chih-Kun Huang

Ming-Che Hsin

Anand Patel

Abhishek Katakwar

Apurva Patel

Vipul D Yagnik

Affiliations

Soon will be listed here.

Abstract

Purpose: Loop duodenojejunal bypass with sleeve gastrectomy (LDJBSG) is effective for weight loss and resolution of obesity-related associated medical problems. However, a description of the reoperative surgery following LDJBSG is lacking.

Material And Methods: In this retrospective study, we analyzed the surgical complications and reoperation (conversion or revision) following LDJBSG from 2011 to 2019 in a single institution.

Results: A total of 337 patients underwent LDJBSG during this period. Reoperative surgery (RS) was required in 10LDJBSG patients (3%). The mean age and BMI before RS were 47 ± 9 years and 28.9 ± 3.6 kg/m, respectively. The mean interval between primary surgery and RS for early (n = 5) and late (n = 5)complications was 8 ± 11 days and 32 ± 15.8 months, respectively. The conversion procedures were Roux-en-Y gastric bypass(n = 5), followed by Roux-en-Y duodenojejunal bypass (n = 2) and one-anastomosis gastric bypass (n = 1); other revision procedures were seromyotomy (n = 1) and re-laparoscopy (n = 1). Perioperative complications were observed in four patients after conversion surgery such as multiorgan failure (n = 1), re-laparoscopy (n = 1), marginal ulcer (n = 1), GERD (n = 1), and dumping syndrome (n = 1).

Conclusion: LDJBSG has low reoperative rates and conversion RYGB could effectively treat the early and late complications of LDJBSG. Because of its technical demands and risk of perioperative complications, conversion surgery should be reserved for a selected group of patients and performed by an experienced metabolic bariatric surgical team.

References

Lee J, Brancati F, Yeh H . Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States National Health Interview Survey, 1997-2008. Diabetes Care. 2011; 34(2):353-7. PMC: 3024348. DOI: 10.2337/dc10-0746. View

Whiting D, Guariguata L, Weil C, Shaw J . IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011; 94(3):311-21. DOI: 10.1016/j.diabres.2011.10.029. View

Huang C, Tai C, Chang P, Malapan K, Tsai C, Yolsuriyanwong K . Loop Duodenojejunal Bypass with Sleeve Gastrectomy: Comparative Study with Roux-en-Y Gastric Bypass in Type 2 Diabetic Patients with a BMI <35 kg/m(2), First Year Results. Obes Surg. 2016; 26(10):2291-301. DOI: 10.1007/s11695-016-2118-z. View

Seki Y, Kasama K, Haruta H, Watanabe A, Yokoyama R, Porciuncula J . Five-Year-Results of Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass for Weight Loss and Type 2 Diabetes Mellitus. Obes Surg. 2016; 27(3):795-801. DOI: 10.1007/s11695-016-2372-0. View

Raj P, Kumaravel R, Chandramaliteeswaran C, Rajpandian S, Palanivelu C . Is laparoscopic duodenojejunal bypass with sleeve an effective alternative to Roux en Y gastric bypass in morbidly obese patients: preliminary results of a randomized trial. Obes Surg. 2011; 22(3):422-6. DOI: 10.1007/s11695-011-0507-x. View

Ser K, Lee W, Chen J, Tsai P, Chen S, Lee Y . Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): Surgical risk and long-term results. Surg Obes Relat Dis. 2019; 15(2):236-243. DOI: 10.1016/j.soard.2018.11.020. View

Lee W, Lee K, Kasama K, Seiki Y, Ser K, Chun S . Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): short-term result and comparison with gastric bypass. Obes Surg. 2013; 24(1):109-13. DOI: 10.1007/s11695-013-1067-z. View

Surve A, Cottam D, Sanchez-Pernaute A, Torres A, Roller J, Kwon Y . The incidence of complications associated with loop duodeno-ileostomy after single-anastomosis duodenal switch procedures among 1328 patients: a multicenter experience. Surg Obes Relat Dis. 2018; 14(5):594-601. DOI: 10.1016/j.soard.2018.01.020. View

Brethauer S, Kothari S, Sudan R, Williams B, English W, Brengman M . Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis. 2014; 10(5):952-72. DOI: 10.1016/j.soard.2014.02.014. View

10.

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

11.

Bohdjalian A, Langer F, Shakeri-Leidenmuhler S, Gfrerer L, Ludvik B, Zacherl J . Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010; 20(5):535-40. DOI: 10.1007/s11695-009-0066-6. View

12.

Baig S, Priya P, Mahawar K, Shah S . Weight Regain After Bariatric Surgery-A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group. Obes Surg. 2019; 29(5):1583-1592. DOI: 10.1007/s11695-019-03734-6. View

13.

Sudan R, Nguyen N, Hutter M, Brethauer S, Ponce J, Morton J . Morbidity, mortality, and weight loss outcomes after reoperative bariatric surgery in the USA. J Gastrointest Surg. 2014; 19(1):171-8. DOI: 10.1007/s11605-014-2639-5. View

14.

Arterburn D, Wellman R, Emiliano A, Smith S, Odegaard A, Murali S . Comparative Effectiveness and Safety of Bariatric Procedures for Weight Loss: A PCORnet Cohort Study. Ann Intern Med. 2018; 169(11):741-750. PMC: 6652193. DOI: 10.7326/M17-2786. View

15.

Yang P, Chen B, Xiang S, Lin X, Luo F, Li W . Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: Results from a meta-analysis of randomized controlled trials. Surg Obes Relat Dis. 2019; 15(4):546-555. DOI: 10.1016/j.soard.2019.02.001. View

16.

Johnson W, Fernanadez A, Farrell T, Macdonald K, Grant J, McMahon R . Surgical revision of loop ("mini") gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007; 3(1):37-41. DOI: 10.1016/j.soard.2006.09.012. View

17.

Frezza E, Reddy S, Gee L, Wachtel M . Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2008; 19(6):684-7. DOI: 10.1007/s11695-008-9677-6. View

18.

Mika A, Kaska L, Proczko-Stepaniak M, Chomiczewska A, Swierczynski J, Smolenski R . Evidence That the Length of Bile Loop Determines Serum Bile Acid Concentration and Glycemic Control After Bariatric Surgery. Obes Surg. 2018; 28(11):3405-3414. DOI: 10.1007/s11695-018-3314-9. View

19.

Ghiassi S, Higa K, Chang S, Ma P, Lloyd A, Boone K . Conversion of standard Roux-en-Y gastric bypass to distal bypass for weight loss failure and metabolic syndrome: 3-year follow-up and evolution of technique to reduce nutritional complications. Surg Obes Relat Dis. 2018; 14(5):554-561. DOI: 10.1016/j.soard.2018.01.004. View

20.

Abdelgawad M, De Angelis F, Iossa A, Rizzello M, Cavallaro G, Silecchia G . Management of Complications and Outcomes After Revisional Bariatric Surgery: 3-Year Experience at a Bariatric Center of Excellence. Obes Surg. 2016; 26(9):2144-2149. DOI: 10.1007/s11695-016-2071-x. View